title: Simultaneous BK Polyomavirus (BKPyV)-associated nephropathy and hemorrhagic cystitis after living donor kidney transplantation.
abstract: BK polyomavirus (BKPyV) commonly reactivates after kidney transplantation, and can cause polyomavirus-associated nephropathy (PyVAN), whereas after allogeneic stem cell transplantation the most frequent manifestation of BKPyV is polyomavirus-associated hemorrhagic cystitis (PyVHC). Despite high-level BKPyV replication in both, the pathogenesis and manifestation of both BKPyV entities appears to differ substantially. We describe an unusual case of simultaneous PyVAN and PyVHC presenting with acute symptoms in a BKPyV-IgG positive recipient eight months after kidney transplantation from a haploidentical living donor, who was BKPyV-IgG negative. Symptoms of cystitis and viremia subsided rapidly after reduction of immunosuppression.
authors.affiliation: Transplantation and Liver Surgery, University of Helsinki and Helsinki University Hospital, PO Box 372, FI 00029HUS, Helsinki, Finland. Electronic address: Ilkka.helantera@helsinki.fi.
authors.forename: Ilkka
authors.initials: I
authors.lastname: Helanterä
authors.affiliation: Transplantation and Clinical Virology, Department of Biomedicine, University of Basel, Petersplatz 10, CH-4009 Basel, Switzerland; Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
authors.forename: Hans H
authors.initials: HH
authors.lastname: Hirsch
authors.affiliation: Transplantation and Clinical Virology, Department of Biomedicine, University of Basel, Petersplatz 10, CH-4009 Basel, Switzerland; Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
authors.forename: Marion
authors.initials: M
authors.lastname: Wernli
authors.affiliation: Department of Nephrology, University of Helsinki and Helsinki University Hospital, PO Box 372, FI 00029HUS, Helsinki, Finland.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Ortiz
authors.affiliation: Transplantation and Liver Surgery, University of Helsinki and Helsinki University Hospital, PO Box 372, FI 00029HUS, Helsinki, Finland.
authors.forename: Marko
authors.initials: M
authors.lastname: Lempinen
authors.affiliation: Department of Pathology, University of Helsinki and Helsinki University Hospital (HUSLAB), PO Box 400, FI 00029HUS Helsinki, Finland.
authors.forename: Anne
authors.initials: A
authors.lastname: Räisänen-Sokolowski
authors.affiliation: Department of Virology, University of Helsinki and Helsinki University Hospital (HUSLAB), PO Box 400, FI 00029HUS, Helsinki, Finland.
authors.forename: Eeva
authors.initials: E
authors.lastname: Auvinen
authors.affiliation: Department of Virology, University of Helsinki and Helsinki University Hospital (HUSLAB), PO Box 400, FI 00029HUS, Helsinki, Finland.
authors.forename: Laura
authors.initials: L
authors.lastname: Mannonen
authors.affiliation: Department of Virology, University of Helsinki and Helsinki University Hospital (HUSLAB), PO Box 400, FI 00029HUS, Helsinki, Finland.
authors.forename: Irmeli
authors.initials: I
authors.lastname: Lautenschlager
mesh_terms: D000328:Adult; D003556:Cystitis / Q000150:complications* / Q000473:pathology / Q000821:virology; D006470:Hemorrhage / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000821:virology; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007674:Kidney Diseases / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D027601:Polyomavirus Infections / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000821:virology; D011183:Postoperative Complications; D014766:Viremia
keywords: BK polyomavirus; Kidney transplantation; Polyomavirus-associated hemorrhagic cystitis; Polyomavirus-associated nephropathy