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Kidney Allograft Dysfunction Due to John Cunningham (JC) Virus Nephropathy
Neeraj Sharma1, Samer Abdulkhalek2
1Department of Nephrology, University of Southern California, Los Angeles, USA.
Cureus
|January 5, 2023
Summary
John Cunningham virus-associated nephropathy (JC-PVAN) is a rare post-transplant complication. This case highlights JC-PVAN in a kidney transplant recipient, emphasizing the need for awareness and management strategies.
Area of Science:
- Nephrology
- Virology
- Transplantation immunology
Background:
- BK polyomavirus (BKPyV) is a common post-kidney transplant infection.
- JC polyomavirus (JCPyV) infections and their impact on graft function are less understood.
- JC polyomavirus-associated nephropathy (JC-PVAN) is a rare cause of polyomavirus-associated nephropathy (PVAN).
Observation:
- A kidney transplant recipient developed allograft dysfunction six years post-transplant.
- The dysfunction was diagnosed as JC-PVAN.
- JC viremia was detected.
Findings:
- JC viremia resolved after immunosuppression reduction and intravenous immunoglobulin (IVIG) treatment.
- Despite viremia resolution, the patient developed acute cellular rejection.
- This led to moderate fibrosis and chronic kidney disease in the allograft.
Implications:
- This case underscores the importance of considering JC-PVAN in kidney transplant recipients with unexplained allograft dysfunction.
- Management involves addressing both viral infection and subsequent rejection.
- Further research is needed to understand JCPyV's role in kidney transplantation.
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