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Concurrent cytomegalovirus glomerulitis and BK polyomavirus‐associated nephropathy in a kidney allograft biopsy
Author(s) -
Chikeka I.O.,
Paulk A.,
Haririan A.,
Papadimitriou J.C.,
Drachenberg C.B.
Publication year - 2016
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12498
Subject(s) - medicine , immunosuppression , biopsy , cytomegalovirus , nephropathy , kidney transplantation , polyomavirus infections , bk virus , renal biopsy , transplantation , urology , pathology , gastroenterology , herpesviridae , immunology , viral disease , virus , endocrinology , diabetes mellitus
A 58‐year‐old renal transplant recipient underwent biopsy 11 weeks post transplantation for increasing creatinine. The biopsy showed cytomegalovirus ( CMV ) glomerulitis together with BK polyomavirus ( BKP yV)‐associated nephropathy ( PVAN ). Treatment with intravenous ganciclovir and overall reduction in maintenance immunosuppression resulted in prompt resolution of the CMV glomerulitis, but with persistence of PVAN in a follow‐up biopsy 4 weeks later. Stable creatinine and BKP yV viral clearance were observed at the last clinical visit 15 months post transplantation. This case exemplifies infectious glomerulitis, which requires differentiation from the more common glomerulitis caused by antibody‐mediated allograft rejection. The morphological similarities and differences between BKP yV and CMV infections are discussed.