Bibliographic Details
| Title: |
BK polyomavirus nephropathy in two kidney transplant patients with distinct diagnostic strategies for BK virus and similar clinical outcomes: two case reports. |
| Authors: |
Figueira Gouvêa, Ana Luisa, Juliboni Cosendey, Rachel Ingrid, Rosa Nascimento, Ana Lucia, Rabe Carvalho, Fabiana, Silva, Andrea Alice, Pinto de Moraes, Heleno, Carrijo Rochael, Mayra, Brandão Varella, Rafael, Gomes Almeida, Stephanie, Reis Almeida, Jorge, Lugon, Jocemir Ronaldo, Gouvêa, Ana Luisa Figueira, Cosendey, Rachel Ingrid Juliboni, Nascimento, Ana Lucia Rosa, Carvalho, Fabiana Rabe, de Moraes, Heleno Pinto, Rochael, Mayra Carrijo, Varella, Rafael Brandão, Almeida, Stephanie Gomes, Almeida, Jorge Reis |
| Source: |
Journal of Medical Case Reports; 5/24/2017, Vol. 11, p1-6, 6p |
| Subject Terms: |
KIDNEY failure, KIDNEY transplant complications, NEPHROTOXICOLOGY, URINARY organ examination, HOMOGRAFTS |
| 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. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
