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Guillain-Barrélike Polyneuropathy After Renal Transplant: Title and subTitle BreakPossible Association With Cytomegalovirus Infection

James F. Bale, Jr, MD; Neal S. Rote, PhD; Linda C. Bloomer, PhD; Patrick F. Bray, MD
[+] Author Affiliations

Accepted for publication April 23, 1980.

Reprints not available.


Arch Neurol. 1980;37(12):784-784. doi:10.1001/archneur.1980.00500610064012
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Guillain-Barré-like polyneuropathy developed in a 40-year-old man three months after a successful kidney transplant. Serologic evidence from blood and CSF suggests that this patient's illness was related to a recent infection with cytomegalovirus.

REPORT OF A CASE  This 40-year-old man had been healthy until 1977, when polydipsia and hematuria developed. Examination at another hospital showed impaired renal function, and in October 1977 an open renal biopsy disclosed changes consistent with rapidly progressive glomerulonephritis. Prednisone was prescribed.On initial admission to the University of Utah Medical Center, Salt Lake City, in November 1978, he appeared chronically ill and had a blood pressure (BP) of 172/110 mm Hg. The results of his neurologic examination were normal. Laboratory studies disclosed deterioration in renal function, with a serum creatine concentration of 15.4 mg/dL and BUN concentration of 125 mg/dL. An arteriovenous shunt was placed and hemodialysis was initiated.In July 1979 the patient

REFERENCES

Howard RJ, Balfour H Jr, Marker SM, et al:  Viral infections in kidney donors and recipients: A prospective study . Transplant Proc 9:113-116, 1977;.
Armstrong JA, Evans AS, Rao N, et al:  Viral infections in renal transplant recipients . Infect Immun 14:970-975, 1976;.
Betts RF, Freeman RB, Douglas RG Jr, et al:  Clinical manifestations of renal allograft derived primary cytomegalovirus infection . Am J Dis Child 131:759-763, 1977;.
Suwansirikul S, Rao N, Dowling JN, et al:  Primary and secondary cytomegalovirus infection: Clinical manifestations after renal transplantation . Arch Intern Med 137:1026-1029, 1977;.
Schneck SA:  Neuropathological features of human organ transplantation: Probable cytomegalovirus infection . J Neuropathol Exp Neurol 24:415-429, 1965;.
Fiala M, Payne JE, Berne TV, et al:  Epidemiology of cytomegalovirus infection after transplantation and immunosuppression . J Infect Dis 132:421-433, 1975;.
Spencer ES:  Clinical aspects of cytomegalovirus infection in kidney-graft recipients . Scand J Infect Dis 6:315-323, 1974;.

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Howard RJ, Balfour H Jr, Marker SM, et al:  Viral infections in kidney donors and recipients: A prospective study . Transplant Proc 9:113-116, 1977;.
Armstrong JA, Evans AS, Rao N, et al:  Viral infections in renal transplant recipients . Infect Immun 14:970-975, 1976;.
Betts RF, Freeman RB, Douglas RG Jr, et al:  Clinical manifestations of renal allograft derived primary cytomegalovirus infection . Am J Dis Child 131:759-763, 1977;.
Suwansirikul S, Rao N, Dowling JN, et al:  Primary and secondary cytomegalovirus infection: Clinical manifestations after renal transplantation . Arch Intern Med 137:1026-1029, 1977;.
Schneck SA:  Neuropathological features of human organ transplantation: Probable cytomegalovirus infection . J Neuropathol Exp Neurol 24:415-429, 1965;.
Fiala M, Payne JE, Berne TV, et al:  Epidemiology of cytomegalovirus infection after transplantation and immunosuppression . J Infect Dis 132:421-433, 1975;.
Spencer ES:  Clinical aspects of cytomegalovirus infection in kidney-graft recipients . Scand J Infect Dis 6:315-323, 1974;.

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