The case of BK virus infection in which it was difficult to differentiate from acute rejection.

BK virus (BKV) nephropathy is one of the major causes of allograft dysfunction or graft loss in kidney transplant recipients. Early diagnosis and timely reduction in immunosuppressant is important for proper treatment. We report a 35-yr-old male case of cadaveric renal transplantation with BK viral related tubulointerstitial nephritis complicated by acute rejection. The diagnostic biopsy showed severe inflammatory infiltrates, tubulitis, and peritubular capillaritis. Discontinuation of mycophenolate mofetil, prednisone pulse therapy, and r-globulin was successful in relieving allograft dysfunction.

Ito Y ，Nishi S ，Imai N ，Yoshita K ，Saito K ，Nakagawa Y ，Takahashi K ，Narita I ... -  《-》

BK polyomavirus nephropathy complicated with acute T-cell-mediated rejection in a kidney transplant recipient: a case report.

We present a case of severe BK polyomavirus nephropathy (BKVN) complicated with persistent acute T-cell-mediated rejection (ATMR) that progressed to allograft failure. A 54-yr-old man received a living donor kidney transplant from his wife. Approximately four months after transplantation, the patient's serum creatinine (SCr) increased from a baseline value of 1.5-2.4 mg/dL. A histological analysis showed BKVN, and the SV40 antigen was detected in the tubular nuclei. The doses of immunosuppressants were reduced, and immunoglobulin was administered intravenously. The SCr increased further, to 5.3 mg/dL, and a second renal biopsy revealed the presence of severe ATMR. Antirejection treatment was performed, and low-dose cidofovir was started. The SCr decreased, to 3 mg/dL, and BK virus antigen in the serum and urine samples became negative at the time of hospital discharge. However, the histological findings subsequently showed gradually progressive interstitial fibrosis and tubular atrophy, and the SCr increased gradually. Two years after the transplantation, the patient resumed hemodialysis. BK polyomavirus nephropathy is usually treated with a reduction in immunosuppressant therapy, although in some patients, the reduction in immunosuppressants induces a subsequent exacerbation of acute rejection and results in progressive graft failure, which suggests difficulty in treating BKVN after kidney transplantation.

Tanabe T ，Shimizu T ，Sai K ，Miyauchi Y ，Shirakawa H ，Ishida H ，Honda K ，Koike J ，Yamaguchi Y ，Tanabe K ... -  《-》

[BK virus nephropathy in a kidney transplant recipient: a case report and literature review].

Hoshi A ，Segawa T ，Takahashi T ，Nakamura E ，Higashi S ，Ito N ，Yamamoto S ，Kamoto T ，Ogawa O ... -  《-》

Low prevalence of BK virus nephropathy on nonprotocol renal biopsies in Iranian kidney transplant recipients: one center's experience and review of the literature.

Soleymanian T ，Rasulzadegan MH ，Sotoodeh M ，Ganji MR ，Naderi G ，Amin M ，Saddadi F ，Hakemi M ，Najafi I ... -  《-》

[Polyomavirus BK nephropathy in renal transplant: 2 cases with different clinical expressions and review of the literature].

Bonofiglio R ，Papalia T ，Caroleo MC ，Mazzucco G ，Merlino C ，Bergallo M ，Giraldi C ，Perugini D ，De Stefano R ，Iuele R ，De Napoli N ... -  《-》