Utility of urinary cytology for diagnosing human polyoma virus infection in transplant recipients: A study of 37 cases with electron microscopic analysis

• Published in: Diagnostic cytopathology 2001-12, Vol.25 (6), p.376-381
• Main Authors: De Las Casas, Luis E., Hoerl, H. Daniel, Bardales, Ricardo H., Pirsch, John D., Sempf, Joan M., Wetzel, Donna J., Stewart III, Jimmie, Oberley, Terry D., Kurtycz, Daniel F.I.
• Format: Article
• Language: English
• Subjects: Adenoviridae - isolation & purification; Adenoviridae - ultrastructure; Adolescent; Adult; Aged; Biological and medical sciences; BK virus; Child; Cytodiagnosis - methods; cytology; Female; human polyoma virus; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Microscopy, Electron; Middle Aged; Miscellaneous. Technology; Organ Transplantation - pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Polyomavirus - isolation & purification; Polyomavirus - ultrastructure; Polyomavirus Infections - diagnosis; Polyomavirus Infections - urine; Postoperative Complications - diagnosis; rejection; renal allograft; Reproducibility of Results; Sensitivity and Specificity; Transplantation, Homologous; Urine - virology
• ISSN: 8755-1039; 1097-0339
• DOI: 10.1002/dc.10023

Human polyoma virus (HPOV) infection is associated with hemorrhagic cystitis, tubulointerstitial nephritis, and renal transplant dysfunction/allograft loss. We evaluated the utility of cytologic examination to detect HPOV infection in 37 urinary cytology (UC) samples (3 bladder washings, and 34 voided samples) from 29 transplant patients, compared to electron microscopic studies (EMS). Evidence of viral infection was found in 11 specimens (30%). Five cases were diagnosed as HPOV by both UC and EMS. One was positive for HPOV by EMS only. Two cases diagnosed as HPOV by UC were demonstrated to be adenovirus (AV) with EMS. Two cases diagnosed as cytomegalovirus (CMV) by EMS had negative UC. One was called HPOV by UC; EMS in this case was negative. Compared to EMS, the sensitivity and specificity of UC for detecting HPOV were 83% and 90%, respectively, with a positive predictive value of 63% and a negative predictive value of 96%. We conclude that UC is a relatively sensitive and specific method for detecting active HPOV infection in transplant patients, and is important in light of the clinical significance of HPOV infection in transplant recipients. The sensitivity and accuracy of UC for diagnosing HPOV can be increased by adding EMS. Diagn. Cytopathol. 25:376–381, 2001. © 2001 Wiley‐Liss, Inc.