Presentation
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. [ncbi.nlm.nih.gov]
Gastrointestinal
- Chronic Diarrhea
Herein we describe the first case of BKV positive invasive urothelial carcinoma within the renal allograft, presenting with chronic diarrhea and weight loss 5 years following resolution of BK viremia/nephropathy (BKVN). [ncbi.nlm.nih.gov]
Workup
The workup supported the clear diagnosis of BK virus nephropathy with tubulointerstitial changes, and the patient responded favorably to intravenous immunoglobulin therapy. [ncbi.nlm.nih.gov]
Serum
- Creatinine Increased
We observed an association of creatinine increase (about 20 µmol/l at time of onset of BK viruria) with BK viruria (Pearson's correlation 0.64; p = 0.01), and BK viruria is significantly linked to acute renal failure (Pearson's correlation 0.35; p = 0.029 [ncbi.nlm.nih.gov]
Kosuke Masutani, Akihiro Tsuchimoto, Yuta Matsukuma, Kei Kurihara, Takehiro Nishiki, Hidehisa Kitada, Masao Tanaka, Takanari Kitazono and Kazuhiko Tsuruya, Temporal serum creatinine increase and exacerbation of tubulointerstitial inflammation during the [doi.org]
- Immunoglobulin A Decreased
Intravenous infusion of pooled immunoglobulins could decrease BK viral load in the plasma, as demonstrated in a small study of kidney transplant recipients. Randomized controlled studies are needed to determine efficacy. [infectiousdiseaseadvisor.com]
- Creatinine Decreased
Repeat biopsy showed overt BK viral nephropathy, and BKV and creatinine decreased only after reduction in immunosuppression and initiation of leflunomide. [ncbi.nlm.nih.gov]
Microbiology
- Treponema Pallidum
The donors fulfilled all criteria required for blood donation, including serologic and PCR negativity for hepatitis B virus (HBV), hepatitis C virus (HCV), HIV, and Treponema pallidum Polyomavirus molecular diagnostic assays BKV and JCV loads were quantified [doi.org]
- Pseudomonas
The patient was still dialysis-dependent when he died from Pseudomonas sepsis 13 months after HCT. A critical review of the literature and the treatment modalities for post-HCT PVAN are provided. [ncbi.nlm.nih.gov]
Other Pathologies
- White Matter Lesions
Brain magnetic resonance image revealed a new white matter lesion in the splenium. On immunohistochemistry, there was SV40-positive staining in gastric and heart biopsy specimens. [ncbi.nlm.nih.gov]
Treatment
The uses of current treatment options are still questionable. Our audit confirms that reducing immunosuppression appears to be the criterian standard for the treatment of BK nephropathy. [ncbi.nlm.nih.gov]
Prognosis
Extensive literature review carried out by the pharmacist to look into the prevalence, prognosis and treatment of BK nephropathy. [ncbi.nlm.nih.gov]
Each transplant requires multiple pre- and post-transplant screenings to monitor patient health, prognosis and risk of organ graft rejection. [elitechgroup.com]
What should you tell the family about the patient's prognosis? Up to 20-30% of patients with BK virus associated nephropathy can lose the transplanted kidney graft. [infectiousdiseaseadvisor.com]
Etiology
We present a review of the clinically oriented literature about BK virus, a relative of JC virus, which is the etiologic agent of progressive multifocal leukoencephalopathy (PML). [ncbi.nlm.nih.gov]
Abstract BK virus (BKV) causes persistent and asymptomatic infections in most humans and is the etiologic agent of polyomavirus-associated nephropathy (PVAN) and other pathologies. [aran.library.nuigalway.ie]
Transplant. 12, 1199 (2012), Abstract ; Full Text Evaluation of human polyomavirus BK as a potential cause of villitis of unknown etiology and spontaneous abortion : M.M. Cajaiba, et al.; J. Med. [enzolifesciences.com]
Epidemiology
This study aimed to evaluate epidemiology of BKVAN and its situation in Thailand. METHODS: A retrospective analysis was conducted among adult kidney transplant recipients at Ramathibodi Hospital from October 2011 to September 2016. [ncbi.nlm.nih.gov]
Evolution of the polyomavirus: epidemiological, anthropological and clinical implications. Rev Med Virol. 2009; 19: 185–199. 6. Zhong S, Randawa PS, Ikegaya H, Chen Q, Zheng HY, Suzuki M. et al. [jpccr.eu]
Pathophysiology
Now that BK virus can be identified by use of specific and sensitive techniques, careful evaluation of the clinical and pathologic presentations of patients with BK virus will allow us to form a clearer picture of viral-associated pathophysiology in many [ncbi.nlm.nih.gov]
Useful For Suggests clinical disorders or settings where the test may be helpful Rapid detection of BK virus DNA Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Polyomaviruses [mayomedicallaboratories.com]
[…] of case reports describing BKV-associated urothelial carcinomas and the growing body of data to support this possible viral oncogenic role, there remains a need for conclusive evidence of BKV involvement in carcinogenesis, and an elucidation of the pathophysiologic [gotoper.com]
Prevention
BACKGROUND: In vitro and retrospective studies of kidney-transplant patients have shown that quinolones can efficiently prevent BK virus (BKV) replication. [ncbi.nlm.nih.gov]
This paves the way for further work of pharmacological agents to 'prevent' BK viruria. [nephjc.com]