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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2011  |  Volume : 22  |  Issue : 1  |  Page : 107-111
Fulminant hepatitis following primary herpes simplex virus infection in renal transplant recipients

1 Renal Transplant Unit, Royal Free Hospital, London, UK
2 Virology Unit, Royal Free Hospital, London, UK

Correspondence Address:
A Al Midani
Assad University Hospital, Damascus, Syria

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PMID: 21196623

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Fulminant hepatic failure (FHF) is a rare but well-recognized complication of pri­mary herpes simplex virus (HSV) infection in immunocompromised patients. Here, we report two cases of acute hepatitis and FHF secondary to primary HSV type 1 infection following renal transplantation in the absence of any mucocutaneous manifestation. High levels of HSV type-1 DNA were detected in the blood. Both patients were seronegative for HSV 1 and HSV 2 immuno­globulin G (IgG) before transplantation, whereas the donor of patient 1 was HSV 1 IgG-positive but had no viremia and the donor of patient 2 was HSV-seronegative. Patient 1 recovered with acyclovir and immunoglobulin whereas patient 2 did not respond and succumbed to death. HSV­seronegative patients are potentially at risk of developing severe primary HSV disease following transplantation, particularly in the absence of routine anti-viral prophylaxis. HSV infection should always be excluded in transplant patients with hepatic dysfunction.

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