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BMJ Case Rep. 2015 Aug 28;2015. pii: bcr2015211564. doi: 10.1136/bcr-2015-211564.

Polyomavirus nephropathy of the native kidney in a patient with rheumatoid arthritis and pulmonary fibrosis.

Author information

1
Department of Pathology, University of Kansas Medical Center, Kansas City, Kansas, USA.
2
Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.

Abstract

Polyomavirus nephropathy is commonly seen in the renal allograft setting but is uncommon in native kidneys. This paper describes polyomavirus nephropathy that developed in the native kidneys of a patient following immunosuppressive therapy for rheumatoid arthritis/Sjögren's syndrome associated lung disease. The patient presented with dyspnoea and a slow steady rise in serum creatinine. Owing to chronic immunosuppression, calcineurin-inhibitor toxicity was suspected. However, renal biopsy revealed polyomavirus nephropathy. The treatment of choice, lowered immunosuppression, was complicated by exacerbation of the patient's lung disease. This case highlights features of polyomavirus nephropathy in the native kidney, as well as the difficulty in its treatment when immunosuppressive treatment is necessary for medical comorbidities.

PMID:
26318171
PMCID:
PMC4693117
DOI:
10.1136/bcr-2015-211564
[Indexed for MEDLINE]
Free PMC Article

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