BK polyomavirus nephropathy in two kidney transplant patients with distinct diagnostic strategies for BK virus and similar clinical outcomes: two case reports
Abstract Background BK polyomavirus-associated nephropathy is an important cause of post-transplantation renal failure. We present two cases of BK polyomavirus-associated nephropathy who were submitted to contrasting strategies of clinical follow-up to BK polyomavirus reactivation, but progressed to...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-05-01
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| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13256-017-1300-9 |
| _version_ | 1819158596900880384 |
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| author | Ana Luisa Figueira Gouvêa Rachel Ingrid Juliboni Cosendey Ana Lucia Rosa Nascimento Fabiana Rabe Carvalho Andrea Alice Silva Heleno Pinto de Moraes Mayra Carrijo Rochael Rafael Brandão Varella Stephanie Gomes Almeida Jorge Reis Almeida Jocemir Ronaldo Lugon |
| author_facet | Ana Luisa Figueira Gouvêa Rachel Ingrid Juliboni Cosendey Ana Lucia Rosa Nascimento Fabiana Rabe Carvalho Andrea Alice Silva Heleno Pinto de Moraes Mayra Carrijo Rochael Rafael Brandão Varella Stephanie Gomes Almeida Jorge Reis Almeida Jocemir Ronaldo Lugon |
| author_sort | Ana Luisa Figueira Gouvêa |
| collection | DOAJ |
| description | Abstract Background BK polyomavirus-associated nephropathy is an important cause of post-transplantation renal failure. We present two cases of BK polyomavirus-associated nephropathy who were submitted to contrasting strategies of clinical follow-up to BK polyomavirus reactivation, but progressed to a similar final outcome. Case presentation Case 1 is a 37-year-old white man whose graft had never presented a good glomerular filtration rate function, with episodes of tacrolimus nephrotoxicity, and no urinary monitoring for BK polyomavirus; stage B BK polyomavirus-associated nephropathy was diagnosed by biopsy at 14 months post-transplant. Despite clinical treatment (dosage decrease and immunosuppressive drug change), he progressed to stage C BK polyomavirus-associated nephropathy and loss of graft function 30 months post-transplant. Case 2 is a 49-year-old mulatto man in his second renal transplantation who was submitted to cytological urinary monitoring for BK polyomavirus; he presented early, persistent, and massive urinary decoy cell shedding and concomitant tacrolimus nephrotoxicity. Even with decreasing immunosuppression, he developed BK polyomavirus-associated nephropathy 1-year post-transplant. Loss of graft function occurred 15 months post-transplant. Conclusions Cytological urinary monitoring was an efficient strategy for monitoring BK virus reactivation. Decoy cell shedding may be related to BK polyomavirus-associated nephropathy when extensive and persistent. The presence of associated tacrolimus nephrotoxicity may be a confounding factor for the clinical diagnosis of BK polyomavirus-associated nephropathy. |
| first_indexed | 2024-12-22T16:27:11Z |
| format | Article |
| id | doaj.art-c5e5cf55a1a4451a8547e7263417df6d |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-22T16:27:11Z |
| publishDate | 2017-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-c5e5cf55a1a4451a8547e7263417df6d2022-12-21T18:20:08ZengBMCJournal of Medical Case Reports1752-19472017-05-011111610.1186/s13256-017-1300-9BK polyomavirus nephropathy in two kidney transplant patients with distinct diagnostic strategies for BK virus and similar clinical outcomes: two case reportsAna Luisa Figueira Gouvêa0Rachel Ingrid Juliboni Cosendey1Ana Lucia Rosa Nascimento2Fabiana Rabe Carvalho3Andrea Alice Silva4Heleno Pinto de Moraes5Mayra Carrijo Rochael6Rafael Brandão Varella7Stephanie Gomes Almeida8Jorge Reis Almeida9Jocemir Ronaldo Lugon10Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas (LAMAP), Department of Clinical Medicine, Universidade Federal FluminenseLaboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas (LAMAP), Department of Clinical Medicine, Universidade Federal FluminenseDepartment of Pathology, Universidade Federal FluminenseLaboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas (LAMAP), Department of Clinical Medicine, Universidade Federal FluminenseLaboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas (LAMAP), Department of Clinical Medicine, Universidade Federal FluminenseDepartment of Pathology, Universidade do Estado do Rio de JaneiroDepartment of Pathology, Universidade Federal FluminenseLaboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas (LAMAP), Department of Clinical Medicine, Universidade Federal FluminenseDepartment of Preventive Medicine, Universidade Federal do Rio de JaneiroLaboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas (LAMAP), Department of Clinical Medicine, Universidade Federal FluminenseLaboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas (LAMAP), Department of Clinical Medicine, Universidade Federal FluminenseAbstract Background BK polyomavirus-associated nephropathy is an important cause of post-transplantation renal failure. We present two cases of BK polyomavirus-associated nephropathy who were submitted to contrasting strategies of clinical follow-up to BK polyomavirus reactivation, but progressed to a similar final outcome. Case presentation Case 1 is a 37-year-old white man whose graft had never presented a good glomerular filtration rate function, with episodes of tacrolimus nephrotoxicity, and no urinary monitoring for BK polyomavirus; stage B BK polyomavirus-associated nephropathy was diagnosed by biopsy at 14 months post-transplant. Despite clinical treatment (dosage decrease and immunosuppressive drug change), he progressed to stage C BK polyomavirus-associated nephropathy and loss of graft function 30 months post-transplant. Case 2 is a 49-year-old mulatto man in his second renal transplantation who was submitted to cytological urinary monitoring for BK polyomavirus; he presented early, persistent, and massive urinary decoy cell shedding and concomitant tacrolimus nephrotoxicity. Even with decreasing immunosuppression, he developed BK polyomavirus-associated nephropathy 1-year post-transplant. Loss of graft function occurred 15 months post-transplant. Conclusions Cytological urinary monitoring was an efficient strategy for monitoring BK virus reactivation. Decoy cell shedding may be related to BK polyomavirus-associated nephropathy when extensive and persistent. The presence of associated tacrolimus nephrotoxicity may be a confounding factor for the clinical diagnosis of BK polyomavirus-associated nephropathy.http://link.springer.com/article/10.1186/s13256-017-1300-9BK polyomavirusBK-associated nephropathyDecoy cellUrinary monitoringRenal transplantAllograft dysfunction infectious disease |
| spellingShingle | Ana Luisa Figueira Gouvêa Rachel Ingrid Juliboni Cosendey Ana Lucia Rosa Nascimento Fabiana Rabe Carvalho Andrea Alice Silva Heleno Pinto de Moraes Mayra Carrijo Rochael Rafael Brandão Varella Stephanie Gomes Almeida Jorge Reis Almeida Jocemir Ronaldo Lugon BK polyomavirus nephropathy in two kidney transplant patients with distinct diagnostic strategies for BK virus and similar clinical outcomes: two case reports Journal of Medical Case Reports BK polyomavirus BK-associated nephropathy Decoy cell Urinary monitoring Renal transplant Allograft dysfunction infectious disease |
| title | BK polyomavirus nephropathy in two kidney transplant patients with distinct diagnostic strategies for BK virus and similar clinical outcomes: two case reports |
| title_full | BK polyomavirus nephropathy in two kidney transplant patients with distinct diagnostic strategies for BK virus and similar clinical outcomes: two case reports |
| title_fullStr | BK polyomavirus nephropathy in two kidney transplant patients with distinct diagnostic strategies for BK virus and similar clinical outcomes: two case reports |
| title_full_unstemmed | BK polyomavirus nephropathy in two kidney transplant patients with distinct diagnostic strategies for BK virus and similar clinical outcomes: two case reports |
| title_short | BK polyomavirus nephropathy in two kidney transplant patients with distinct diagnostic strategies for BK virus and similar clinical outcomes: two case reports |
| title_sort | bk polyomavirus nephropathy in two kidney transplant patients with distinct diagnostic strategies for bk virus and similar clinical outcomes two case reports |
| topic | BK polyomavirus BK-associated nephropathy Decoy cell Urinary monitoring Renal transplant Allograft dysfunction infectious disease |
| url | http://link.springer.com/article/10.1186/s13256-017-1300-9 |
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