Native BK viral nephropathy in a pediatric heart transplant recipient.
BK viral nephropathy is a well-documented clinical entity in kidney transplant recipients and a significant cause of morbidity and allograft loss in affected patients. BK viral nephropathy in native kidneys of non-kidney transplant recipients is relatively uncommon, but has been reported in adult patients. We report the occurrence of BK viral nephropathy in a pediatric heart transplant recipient. A 10-yr-old boy with past history of Ewing's sarcoma underwent heart transplantation for dilated cardiomyopathy induced by previous chemotherapy with doxorubicin. Post-transplant course was complicated by grade 3A rejection and CMV colitis. He was diagnosed with native BK viral nephropathy approximately 18 months post-transplant due to mild, but persistent, elevation in serum creatinine associated with proteinuria. BK viral nephropathy affects non-kidney transplant recipients, and a high index of suspicion is necessary for early diagnosis and management of this condition.
Ali
Farah N
FN
Division of Kidney Diseases, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60614, USA. fnaseer@childrensmemorial.org
Meehan
Shane M
SM
Pahl
Elfriede
E
Cohn
Richard A
RA
D000903:Antibiotics, Antineoplastic / Q000009:adverse effects; D001739:BK Virus / Q000302:isolation & purification*; D001706:Biopsy; D002311:Cardiomyopathy, Dilated / Q000139:chemically induced / Q000601:surgery*; D002648:Child; D004317:Doxorubicin / Q000009:adverse effects; D016027:Heart Transplantation; D006801:Humans; D007674:Kidney Diseases / Q000473:pathology* / Q000821:virology*; D008297:Male; D027601:Polyomavirus Infections / Q000473:pathology* / Q000821:virology*; D014412:Tumor Virus Infections / Q000473:pathology* / Q000821:virology*
D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin