title: Polyomavirus associated nephropathy after kidney and pancreas transplantation: case report.
abstract: Polyomavirus virus associated nephropathy (PVAN) is an important cause of graft failure in the renal transplant population. The prevalence of PVAN has increased from 1% to 10% in the past decade, leading to loss of transplanted organ in 30% to 80% of cases. In the absence of specific antiviral drugs, early detection of disease and modification/reduction of immunosuppressive regimen is currently the cornerstone of therapy. In the setting of multiorgan transplantation, like simultaneous pancreas and kidney transplantation (SPKT), diagnosis and therapy of PVAN can be even more challenging problem. We report a first described case of PVAN in patient after SPKT in Croatia. Patient is a 32 years old Caucasian male with type 1 diabetes mellitus and end stage renal failure, diagnosed for PVAN 6 month after SPKT. Patient was treated with reduced immunosuppressive regimen. At 32 month follow up, patient has preserved kidney and pancreas function with estimated glomerular filtration (eGFR) rate of 91 mL/min and no signs of PVAN on his 2 year protocol kidney biopsy.
authors.affiliation: Department of Nephrology, "Merkur" University Hospital, Zagreb, Croatia. sonja.gracin@gmail.com
authors.forename: Sonja
authors.initials: S
authors.lastname: Gracin
authors.forename: Ivana Kovacević
authors.initials: IK
authors.lastname: Vojtusek
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Vidas
authors.forename: Mladen
authors.initials: M
authors.lastname: Knotek
authors.forename: Ika Kardum
authors.initials: IK
authors.lastname: Skelin
authors.forename: Danica
authors.initials: D
authors.lastname: Ljubanović
mesh_terms: D004847:Epithelial Cells / Q000473:pathology / Q000821:virology; D006801:Humans; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000097:blood / Q000627:therapeutic use; D007674:Kidney Diseases / Q000473:pathology / Q000821:virology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D016035:Pancreas Transplantation / Q000009:adverse effects*; D027601:Polyomavirus Infections / Q000473:pathology*; D014617:Vacuoles / Q000648:ultrastructure; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents