Acute hemorrhagic cystitis by adenovirus type 11 with and without type 37 after kidney transplantation

We report 2 kidney transplant patients with acute hemorrhagic cystitis. Adenovirus type 11 was isolated in the urine of both patients and in 1 patient adenovirus type 37 was also isolated. Each developed macrohematuria with urgency, micturition pain, elevated fever and functional deterioration of the transplanted kidney possibly due to acute rejection. These symptoms and laboratory data suggesting renal impairment persisted for approximately 4 weeks after therapy for acute rejection had been started without any specific additional treatment for adenovirus. Serum creatinine levels returned to slightly higher values than before this episode. Histological findings of biopsy specimens from the transplanted kidney in 1 patient indicated that renal impairment was attributable to acute rejection. According to the clinical results of our cases, there were no remarkable differences between adenovirus type 11 infection with or without type 37 infection. Acute hemorrhagic cystitis caused by the adenovirus is an interesting complication after kidney transplantation, especially with regard to kidney impairment and treatment.