title: Unusual presentations of BK virus infections in pediatric renal transplant recipients.
abstract: BKV has emerged as a significant pathogen in the field of transplantation, predominantly causing BKV nephropathy in renal transplant recipients and hemorrhagic cystitis in HSCT recipients. However, case reports describe more diverse complications, and we too present three unusual cases of BKV infections in pediatric renal transplant recipients. First, we describe a case of biopsy-proven renal damage secondary to BKV prior to the onset of viremia, demonstrating that BKV nephropathy can occur without preceding viremia. We also present two renal transplant recipients with persistent BK viruria, one with BKV-associated hemorrhagic cystitis and the other with microscopic hematuria. Therefore, we conclude that BKV manifestations may be more diverse than previously thought and suggest clinical utility in urine BKV qPCR testing in specific transplant recipients.
authors.affiliation: Department of Pediatrics, Fairview and Amplatz Hospital, University of Minnesota Medical Center, Minneapolis, MN, USA. drake097@umn.edu
authors.forename: Keri A
authors.initials: KA
authors.lastname: Drake
authors.forename: Lydia
authors.initials: L
authors.lastname: Najera
authors.forename: Robyn C
authors.initials: RC
authors.lastname: Reed
authors.forename: Priya S
authors.initials: PS
authors.lastname: Verghese
mesh_terms: D000293:Adolescent; D001739:BK Virus / Q000302:isolation & purification*; D001706:Biopsy; D006084:Graft Rejection; D006417:Hematuria / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D016133:Polymerase Chain Reaction; D027601:Polyomavirus Infections / Q000150:complications / Q000175:diagnosis*; D051437:Renal Insufficiency / Q000150:complications* / Q000628:therapy / Q000821:virology; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D014766:Viremia
chemical_list: D007166:Immunosuppressive Agents