Adenoviral infection is a significant cause of morbidity and mortality in immunocompromised patients in the pediatric age group, hepatitis caused by the serotype 5 being the most common manifestation in the liver transplant recipient. The authors report a case of a 3 1/2-year-old child in whom fatal adenoviral hepatitis developed after liver transplantation for syndromic paucity of the intrahepatic bile ducts. Allograft biopsy at 14 days showed early changes of microabscesses in the parenchyma but no inclusions. Immunohistochemistry using an adenovirus-group antibody (MAB805, Chemicon International, Harrow, England), however, demonstrated nuclear positivity in hepatocytes related to and at a distance from the lesions. As antibody titers are unreliable in an immunocompromised patient and culture results take time, immunohistochemistry for adenovirus offers a rapid diagnosis. The technique is economic and has a clear advantage on the more demanding electron microscopic screening, which was performed in the case as additional evidence. Immunohistochemistry for adenovirus should be done routinely in the presence of microabscesses to differentiate the lesion from hepatitis due to cytomegalovirus.
- Liver transplantation
ASJC Scopus subject areas
- Pathology and Forensic Medicine