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Transpl Infect Dis. 2017 Feb;19(1). doi: 10.1111/tid.12646. Epub 2017 Jan 17.

A kidney transplant recipient with renal medullary viral cytopathic changes.

Author information

1
Division of Clinical Microbiology, Mayo Clinic, Rochester, MN, USA.
2
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
3
The William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA.
4
Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA.
5
Focus Diagnostics Inc. Reference Laboratory, A Quest Subsidiary, San Juan Capistrano, CA, USA.

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.

KEYWORDS:

BK virus; JC virus; nephropathy; polyomavirus

PMID:
27925350
DOI:
10.1111/tid.12646
[Indexed for MEDLINE]

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