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JC polyomavirus-associated nephropathy in a kidney transplant recipient
Wouter T Moest1, Joris I Rotmans2, Gijs Fortrie3
1Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands w.t.moest@lumc.nl.
BMJ Case Reports
|December 3, 2025
Summary
JC polyomavirus (JCPyV) nephropathy was diagnosed in a kidney transplant recipient with declining graft function. This case highlights the importance of considering JCPyV in transplant patients, even when BK polyomavirus is suspected but not detected.
Area of Science:
- Nephrology
- Transplantation Immunology
- Viral Pathogenesis
Background:
- Kidney transplantation is a life-saving treatment for end-stage kidney disease.
- Long-term graft survival can be threatened by opportunistic viral infections.
- JC polyomavirus (JCPyV) is an under-recognized cause of nephropathy in transplant recipients.
Purpose of the Study:
- To report a case of JC polyomavirus nephropathy in a kidney transplant recipient.
- To emphasize the diagnostic challenges and clinical implications of JCPyV infection post-transplantation.
Main Methods:
- Case report of a patient undergoing donation-after-circulatory-death kidney transplantation.
- Evaluation of declining graft function, including kidney biopsy and immunohistochemistry.
- Quantitative PCR (qPCR) for BK polyomavirus (BKPyV) and JC polyomavirus (JCPyV) in plasma and tissue.
Main Results:
- The patient developed chronic-active tubulointerstitial nephritis.
- BKPyV was not detected, but JCPyV was confirmed by qPCR in plasma and biopsy.
- Graft function continued to decline despite reduced immunosuppression.
Conclusions:
- JC polyomavirus nephropathy should be considered in kidney transplant recipients with declining graft function, especially when BKPyV testing is negative.
- Increased clinical awareness and further research on JCPyV pathogenesis and management are crucial.
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