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Measurement of BK-polyomavirus Non-Coding Control Region Driven Transcriptional Activity Via Flow Cytometry
Published on: July 13, 2019
BK virus nephropathy in a native kidney
Dermot Wildes1, Davina Henderson2, Sinéad Ryan3
1Department of Paediatric Nephrology, Children's Health Ireland, Dublin, Ireland. dermotwildes@rcsi.com.
Background:
BK virus is a polyoma virus which has been associated with impaired graft function in kidney transplant recipients. After primary infection, the virus becomes latent in the renal/urinary epithelium. In immunocompetent hosts, there are usually no pathological sequelae.
Case:
An 11-year-old female on chronic immunosuppression for a severe auto-immune/inflammatory condition was referred to Paediatric Nephrology due to a persistently elevated serum creatinine. Extensive investigation yielded BK viruria and viraemia. Kidney biopsy showed multifocal lymphocytic tubulitis, with cytonuclear changes. Immunohistochemical staining for SV40 was positive, and a diagnosis of native kidney BK virus nephropathy was made.
Conclusion:
We present the first non-malignancy/transplant-associated paediatric case of BK virus nephropathy in a native kidney. In an era of increasing use of immunosuppressive medicines for a variety of indications, clinicians should include BK virus infection in their differential diagnosis for nephropathy in patients on chronic, high-dose immunosuppression.
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