title: Diagnosis of BK viral nephropathy in the renal allograft biopsy: role of fluorescence in situ hybridization.
abstract: Early recognition of BK viral nephropathy is essential for successful management. Our aim in this study was to evaluate a novel fluorescence in situ hybridization (FISH) assay for detection of BK virus in renal transplant biopsies in the context of standard detection methods. Renal allograft biopsies (n = 108) were analyzed via H&E, immunohistochemistry (IHC) for simian virus 40, and FISH for BK virus. BK virus was detected in 16 (14.8%) cases by H&E, 13 (12%) cases by IHC, 18 (16.6%) cases by FISH, and 19 (17.6%) cases by real-time PCR; 24 of 108 showed a discrepancy in ≥1 testing modalities. Comparison of H&E, IHC, and FISH showed no statistical difference in detection of BK virus. However, performing comparisons between the different tissue-based assays in the context of plasma or urine real-time PCR results showed significant improvement in detection of BK by FISH over H&E (P = 0.02) but not IHC (P = 0.07). This novel FISH-based approach for BK virus identification in renal allograft biopsy tissue mirrored real-time PCR results and showed superior performance to detection of inclusions by H&E. Therefore, use of FISH for BK virus detection in the setting of renal allograft biopsy is a useful and sensitive detection method and could be adopted in any laboratory that currently performs FISH analysis.
authors: Department of Molecular Pathology, Cleveland Clinic, Cleveland, Ohio 44195, USA.
authors: Zhen
authors: Z
authors: Wang
authors: Bryce P
authors: BP
authors: Portier
authors: Bo
authors: B
authors: Hu
authors: Andres
authors: A
authors: Chiesa-Vottero
authors: Jonathan
authors: J
authors: Myles
authors: Gary W
authors: GW
authors: Procop
authors: Raymond R
authors: RR
authors: Tubbs
mesh_terms: D000328:Adult; D000368:Aged; D001739:BK Virus / Q000235:genetics / Q000302:isolation & purification*; D001706:Biopsy; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007668:Kidney / Q000473:pathology / Q000821:virology; D007674:Kidney Diseases / Q000473:pathology* / Q000821:virology*; D016030:Kidney Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014184:Transplantation, Homologous; D014412:Tumor Virus Infections / Q000175:diagnosis*; D055815:Young Adult