A kidney transplant recipient with renal medullary viral cytopathic changes

Poornima Ramanan, Elizabeth A. Timmerman, Mary E. Fidler, Hatem Amer, Bobbi S. Pritt, Dale A. Schwab, Hollis J. Batterman, Matthew J. Binnicker

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

We present a case of JC polyomavirus (JCV)-associated nephropathy (PyVAN) in an asymptomatic deceased-donor kidney transplant recipient. Despite the presence of viral cytopathic effect in the kidney biopsy and positive BK polyomavirus (BKV) in situ hybridization (ISH), BKV real-time polymerase chain reaction (PCR) results of plasma and urine were negative. JCV ISH was performed and was found to be positive. JCV real-time PCR on urine, plasma, and the kidney biopsy tissue was positive. Reduction in immunosuppression resulted in resolution of JCV viremia. This case highlights that JC-PyVAN is a distinct clinical entity and is likely to have a better clinical outcome than BK-PyVAN. Concurrent infection with BKV and JCV may occur, but may be difficult to confirm due to the potential for cross-reactivity between BKV and JCV ISH stains.

Original languageEnglish (US)
Article numbere12646
JournalTransplant Infectious Disease
Volume19
Issue number1
DOIs
StatePublished - Feb 1 2017

Keywords

  • BK virus
  • JC virus
  • nephropathy
  • polyomavirus

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases

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    Ramanan, P., Timmerman, E. A., Fidler, M. E., Amer, H., Pritt, B. S., Schwab, D. A., Batterman, H. J., & Binnicker, M. J. (2017). A kidney transplant recipient with renal medullary viral cytopathic changes. Transplant Infectious Disease, 19(1), [e12646]. https://doi.org/10.1111/tid.12646