Concurrent cytomegalovirus glomerulitis and BK polyomavirus-associated nephropathy in a kidney allograft biopsy

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 (BKPyV)‐associated nephropathy (PVAN). Treatment with intravenous ganciclovir and overall reduction in...

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Bibliographic Details
Published in:Transplant infectious disease 2016-04, Vol.18 (2), p.247-250
Main Authors: Chikeka, I.O., Paulk, A., Haririan, A., Papadimitriou, J.C., Drachenberg, C.B.
Format: Article
Language:English
Subjects:
Biopsy
BK polyomavirus-associated nephropathy
BK Virus - isolation & purification
CMV
Cytomegalovirus
Cytomegalovirus - isolation & purification
Cytomegalovirus Infections - diagnosis
Cytomegalovirus Infections - pathology
Cytomegalovirus Infections - virology
glomerulitis
Graft Rejection
Humans
Immunocompromised Host
Kidney - pathology
Kidney - virology
Kidney Glomerulus - pathology
Kidney Glomerulus - virology
Kidney Transplantation - adverse effects
Male
Middle Aged
Polyomavirus Infections - pathology
Polyomavirus Infections - virology
Postoperative Complications
renal biopsy
SV40 stain
Tissue Donors
Transplants & implants
Tumor Virus Infections - pathology
Tumor Virus Infections - virology
viremia
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Description
Summary: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 (BKPyV)‐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 BKPyV 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 BKPyV and CMV infections are discussed.
ISSN:1398-2273
1399-3062
DOI:10.1111/tid.12498