title: Acute diffuse proliferative post-infectious glomerulonephritis in renal allograft--a case report and literature review.
abstract: PVN is a well-known cause of renal allograft dysfunction and failure. The diagnosis is established by examination of tissue from the renal graft, and confirmed by immunohistochemical or in situ hybridization techniques. Electron microscopy can be utilized as an ancillary modality to identify the viral particles ultrastructurally. The tubular epithelial cells are the primary target of PV cytopathic effect; however, PV-associated glomerular changes have also been described. Immune-type electron-dense deposits in the TBMs have been described in the setting of PVN, and rarely, likewise have glomerular subepithelial hump-like deposits. Diffuse immune-mediated proliferative glomerulonephritis in the setting of PVN has not been reported before. In this report, we describe an 11-yr-old kidney transplant recipient boy who developed immune-mediated glomerulonephritis with light microscopic, immunofluorescence, and ultrastructural features compatible with acute PIGN superimposing chronic PVN, discuss this unusual association and the possible mechanisms of antigen clearance in PVN and present a literature review.
authors: Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
authors: Khaled O
authors: KO
authors: Alsaad
authors: Nourah
authors: N
authors: Aloudah
authors: Hanouf M
authors: HM
authors: Alhamdan
authors: Abdulrahman
authors: A
authors: Alamir
authors: Khalid
authors: K
authors: Fakeeh
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001739:BK Virus; D001706:Biopsy; D049109:Cell Proliferation; D002648:Child; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000150:complications; D004847:Epithelial Cells; D005921:Glomerulonephritis / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000150:complications; D016030:Kidney Transplantation / Q000009:adverse effects*; D007684:Kidney Tubules / Q000473:pathology; D008297:Male; D011120:Polyomavirus; D027601:Polyomavirus Infections / Q000473:pathology; D011183:Postoperative Complications; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents
keywords: BK virus; C3; nephropathy; polyomavirus; post-infectious glomerulonephritis; subepithelial deposits