Interstitial nephritis associated with cytomegalovirus infection

Cytomegalovirus (CMV) infection may cause impairment of renal graft function and glomerular and interstitial injury. Whether renal lesions are the consequence of infection or of decreased graft tolerance is uncertain. We studied autogenous renal tissues obtained from two infants with CMV infection. Light and electron microscopy revealed interstitial nephritis, but not glomerulopathy. Analysis of frozen tissues using monoclonal antibodies by indirect immunofluorescence demonstrated that most infiltrating cells were T cells (OKT3+), the majority of which reacted with OKT8. In contrast, tissues obtained from one individual prior to CMV infection, from individuals with end-stage kidney disease, and from normal renal donors revealed either balanced proportions of OKT4+ and OKT8+ cells or a preponderance of the former. Thus, CMV infection may be associated with interstitial nephritis involving a characteristic subpopulation of T cells.