title: Polyomavirus nephropathy of the native kidney in a patient with rheumatoid arthritis and pulmonary fibrosis.
abstract: Polyomavirus nephropathy is commonly seen in the renal allograft setting but is uncommon in native kidneys. This paper describes polyomavirus nephropathy that developed in the native kidneys of a patient following immunosuppressive therapy for rheumatoid arthritis/Sjögren's syndrome associated lung disease. The patient presented with dyspnoea and a slow steady rise in serum creatinine. Owing to chronic immunosuppression, calcineurin-inhibitor toxicity was suspected. However, renal biopsy revealed polyomavirus nephropathy. The treatment of choice, lowered immunosuppression, was complicated by exacerbation of the patient's lung disease. This case highlights features of polyomavirus nephropathy in the native kidney, as well as the difficulty in its treatment when immunosuppressive treatment is necessary for medical comorbidities.
authors: Department of Pathology, University of Kansas Medical Center, Kansas City, Kansas, USA.
authors: Melissa
authors: M
authors: Krystel-Whittemore
authors: Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.
authors: Ellen T
authors: ET
authors: McCarthy
authors: Department of Pathology, University of Kansas Medical Center, Kansas City, Kansas, USA.
authors: Ivan
authors: I
authors: Damjanov
authors: Department of Pathology, University of Kansas Medical Center, Kansas City, Kansas, USA.
authors: Timothy A
authors: TA
authors: Fields
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007674:Kidney Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives; D009894:Opportunistic Infections / Q000150:complications*; D011120:Polyomavirus; D027601:Polyomavirus Infections / Q000150:complications*; D011658:Pulmonary Fibrosis / Q000150:complications; D016559:Tacrolimus / Q000009:adverse effects
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D016559:Tacrolimus