title: Ultrasound findings of BK polyomavirus-associated nephropathy in renal transplant patients.
abstract: BK polyomavirus (BKV) is an emerging pathogen in immunocompromised patients. BKV infection occurs in 1-9 % of renal transplants and causes chronic nephropathy or graft loss. Diagnosis of BKV-associated nephropathy (BKVAN) is based on detection of viruria then viremia and at least a tubule-interstitial nephritis at renal biopsy. This paper describes the ultrasound and color Doppler (US-CD) features of BKVAN. Seventeen patients affected by BKVAN were studied using a linear bandwidth 7-12 MHz probe. Ultrasound showed a widespread streak-like pattern with alternating normal echoic and hypoechoic streaks with irregular edges from the papilla to the cortex. Renal biopsy performed in hypoechoic areas highlighted the typical viral inclusions in tubular epithelial cells. Our experience suggests a possible role for US-CD in the non-invasive diagnosis of BKVAN when combined with blood and urine screening tests. US-CD must be performed with a high-frequency linear probe to highlight the streak-like pattern of the renal parenchyma.
authors.affiliation: Nephrology and Dialysis Department, Ca' Foncello Hospital, Treviso, Italy. maurodugo59@gmail.com.
authors.forename: Mauro
authors.identifier: http://orcid.org/0000-0002-5120-7883
authors.initials: M
authors.lastname: Dugo
authors.affiliation: Nephrology and Dialysis Department, Ca' Foncello Hospital, Treviso, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Mangino
authors.affiliation: S. Anna of Advanced Studies, Internal Medicine University of Pisa, Pisa, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Meola
authors.affiliation: S. Anna of Advanced Studies, Internal Medicine University of Pisa, Pisa, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Petrucci
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Valente
authors.affiliation: Pathology Department, Ca' Foncello Hospital, Treviso, Italy.
authors.forename: Licia
authors.initials: L
authors.lastname: Laurino
authors.affiliation: Pathology Department, Vincenzo Cervello Hospital, Palermo, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Stella
authors.affiliation: Nephrology and Dialysis Department, Ca' Foncello Hospital, Treviso, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Mastrosimone
authors.affiliation: Nephrology and Dialysis Department, Ca' Foncello Hospital, Treviso, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Brunello
authors.affiliation: Nephrology and Dialysis Department, Ca' Foncello Hospital, Treviso, Italy.
authors.forename: Bice
authors.initials: B
authors.lastname: Virgilio
authors.affiliation: Nephrology and Dialysis Department, Ca' Foncello Hospital, Treviso, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Rizzolo
authors.affiliation: Nephrology and Dialysis Department, Ca' Foncello Hospital, Treviso, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Maresca
mesh_terms: D000328:Adult; D000368:Aged; D001739:BK Virus / Q000472:pathogenicity*; D001706:Biopsy; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009393:Nephritis / Q000000981:diagnostic imaging* / Q000821:virology; D027601:Polyomavirus Infections / Q000000981:diagnostic imaging* / Q000821:virology; D011237:Predictive Value of Tests; D014412:Tumor Virus Infections / Q000000981:diagnostic imaging* / Q000821:virology; D018615:Ultrasonography, Doppler, Color
keywords: BK virus; Kidney transplantation; Nephritis; Ultrasonography