Role of urinary cytology in detecting human polyoma bk virus in kidney transplant recipients. A preliminary report.
OBJECTIVE
To report data on the evaluation of the efficacy of urine cytology in detecting BK virus (BKV).


METHODS
Papanicolaou-stained cytospin preparations of randomly collected urine samples from 8 renal transplant (RTR) patients (5 males, 3 females, age: 23-63 years) who previously tested positive for BKV by PCR in urine or blood or both were studied. Urine sediment from 3 of the patients was processed for ultrastructural examination (EM). Renal biopsies before and after BKV detection were also evaluated.


RESULTS
The interval between renal transplant and urine cytology ranged between 2 and 5 years. Urine from females was difficult to assess due to vaginal contamination. In 2 of the 5 urine specimens from male recipients BKV-infected decoy cells were identified. Viral particles suggestive of BKV were identified on EM in 2 of the 3 specimens studied. Kidney biopsies showed morphologic features suggestive of BKV infection in 2 cases, 1 each detected on cytology and EM, respectively.


CONCLUSIONS
Screening for the presence of decoy cells in urine provides a simple sensitive means for the diagnosis of BKV nephropathy in RTR.
Kapila
Kusum
K
Department of Nephrology, Hamad Al-Essa Kidney Transplant Centre, Kuwait. kkapila@hsc.edu.kw
Nampoory
Mangalathillom R N
MR
Johny
Kaivilayil V
KV
Pacsa
Alexander S
AS
Al-Ayadhy
Bushra
B
Mathew
Jessy R
JR
Nair
Madhavan P
MP
Halim
Medhat A
MA
George
Sara S
SS
Francis
Issam M
IM
D000328:Adult; D001739:BK Virus / Q000302:isolation & purification*; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000652:urine*; D012680:Sensitivity and Specificity; D014412:Tumor Virus Infections / Q000652:urine*