BK Polyomavirus Interstitial Nephritis in a Renal Allograft Recipient

Human polyomavirus (PV) interstitial nephritis has recently been recognized as a cause of severe renal allograft dysfunction. It occurs in immunosuppressed patients after reactivation of the latent virus PV type BK (BK virus) in the renal epithelium. BK disease is defined as a morphologically manife...

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Bibliographic Details
Published in:Ultrastructural pathology 2003, Vol.27 (1), p.61-64
Main Authors: Suh, Kwang-Sun, Yeong Kim, Suk, Kee Bang, Byung, Woo Yang, Chul, Min Lee, Jong, Hyun Park, Joo, Kwon Kim, Sung
Format: Article
Language:English
Subjects:
Adult
BK Virus - isolation & purification
BK Virus - ultrastructure
Female
Graft Rejection - pathology
Graft Rejection - virology
Humans
Inclusion Bodies, Viral - ultrastructure
Kidney Transplantation
Nephritis, Interstitial - pathology
Nephritis, Interstitial - virology
Polyomavirus Infections - complications
Polyomavirus Infections - pathology
Postoperative Complications
Tumor Virus Infections - complications
Tumor Virus Infections - pathology
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Summary:Human polyomavirus (PV) interstitial nephritis has recently been recognized as a cause of severe renal allograft dysfunction. It occurs in immunosuppressed patients after reactivation of the latent virus PV type BK (BK virus) in the renal epithelium. BK disease is defined as a morphologically manifest renal infection with cytopathic signs accompanied by varying degrees of interstitial inflammatory cell infiltrates and functional impairment. It is also identified by the presence of cells containing viral inclusion bodies (decoy cells) in the urine. The authors report a case of BK PV interstitial nephritis in a 36-year-old renal allograft recipient. Under light microscopy the chief diagnostic indicator was detection of intranuclear viral inclusions, which were found exclusively in tubular epithelial cells. Cells with viral changes were often enlarged with nuclear atypia and chromatin basophilia. Widespread interstitial plasma cell infiltrates associated with tubulitis were present. Intranuclear paracrystalline arrays of virus particles 35-38 nm in diameter were present as characteristic ultrastructural indicators. Urine samples revealed decoy cells with ground-glass-type intranuclear inclusions positive for BK virus by electron microcopy.
ISSN:0191-3123
1521-0758
DOI:10.1080/01913120309948