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Histological Evolution of BK Virus-Associated Nephropathy: Importance of Integrating Clinical and Pathological Findings.

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons·2017
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Concurrent cytomegalovirus glomerulitis and BK polyomavirus-associated nephropathy in a kidney allograft biopsy.

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BK Polyomavirus Infection and Renourinary Tumorigenesis.

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Bartonella henselae infection-associated vasculitis and crescentic glomerulonephritis leading to renal allograft loss.

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Use of Ultra-high Field MRI in Small Rodent Models of Polycystic Kidney Disease for In Vivo Phenotyping and Drug Monitoring
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Polyomavirus-associated nephropathy: update in diagnosis.

C B Drachenberg1, J C Papadimitriou

  • 1Department of Pathology, University of Maryland School of Medicine, Baltimore, 21201, USA. cdrac001@umaryland.edu

Transplant Infectious Disease : an Official Journal of the Transplantation Society
|June 1, 2006
PubMed
Summary

Diagnosing polyomavirus allograft nephritis (PVAN) in kidney transplants involves renal biopsy and ancillary tests. Histological patterns and viral load in BK polyomavirus infection correlate with graft outcomes.

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Area of Science:

  • Nephrology
  • Virology
  • Transplant Immunology

Background:

  • Polyomavirus allograft nephritis (PVAN) is a significant complication in kidney transplant recipients.
  • Diagnosis relies on renal biopsy showing viral cytopathic changes and ancillary techniques like immunohistochemistry.
  • PVAN presents with distinct histological patterns (A, B, C) reflecting disease severity.

Purpose of the Study:

  • To detail the diagnostic criteria and histological patterns of BK and JC polyomavirus allograft nephritis (PVAN).
  • To correlate histological findings and viral loads with kidney allograft outcomes.
  • To discuss the role of viruria and viremia in PVAN diagnosis and risk stratification.

Main Methods:

  • Histological examination of renal biopsies to identify polyomavirus cytopathic effects.
  • Ancillary techniques such as immunohistochemistry for confirmation.
  • Quantification of BK and JC polyomavirus in urine (viruria) and blood (viremia) using cytology and PCR.

Main Results:

  • Three histological patterns (A, B, C) correlate with early, intermediate, and advanced PVAN.
  • High BK viruria (>10^7/mL) and viremia (>10^4/mL) are characteristic of biopsy-confirmed BK PVAN.
  • JC PVAN is less common, with high viruria (>10^4/mL) and lower viremia (~10^3/mL).

Conclusions:

  • Histological pattern in the initial biopsy predicts graft outcome.
  • A negative biopsy does not exclude PVAN due to its multifocal nature.
  • Viremia is a highly specific diagnostic marker for BK PVAN, while viruria aids in risk identification.