title: A kidney transplant recipient with renal medullary viral cytopathic changes.
abstract: We present a case of JC polyomavirus (JCV)-associated nephropathy (PyVAN) in an asymptomatic deceased-donor kidney transplant recipient. Despite the presence of viral cytopathic effect in the kidney biopsy and positive BK polyomavirus (BKV) in situ hybridization (ISH), BKV real-time polymerase chain reaction (PCR) results of plasma and urine were negative. JCV ISH was performed and was found to be positive. JCV real-time PCR on urine, plasma, and the kidney biopsy tissue was positive. Reduction in immunosuppression resulted in resolution of JCV viremia. This case highlights that JC-PyVAN is a distinct clinical entity and is likely to have a better clinical outcome than BK-PyVAN. Concurrent infection with BKV and JCV may occur, but may be difficult to confirm due to the potential for cross-reactivity between BKV and JCV ISH stains.
authors.affiliation: Division of Clinical Microbiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Poornima
authors.initials: P
authors.lastname: Ramanan
authors.affiliation: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.|The William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Timmerman
authors.affiliation: Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Fidler
authors.affiliation: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.|The William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA.
authors.forename: Hatem
authors.initials: H
authors.lastname: Amer
authors.affiliation: Division of Clinical Microbiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Bobbi S
authors.initials: BS
authors.lastname: Pritt
authors.affiliation: Focus Diagnostics Inc. Reference Laboratory, A Quest Subsidiary, San Juan Capistrano, CA, USA.
authors.forename: Dale A
authors.initials: DA
authors.lastname: Schwab
authors.affiliation: Focus Diagnostics Inc. Reference Laboratory, A Quest Subsidiary, San Juan Capistrano, CA, USA.
authors.forename: Hollis J
authors.initials: HJ
authors.lastname: Batterman
authors.affiliation: Division of Clinical Microbiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Binnicker
mesh_terms: D000961:Antilymphocyte Serum / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001739:BK Virus / Q000302:isolation & purification; D001706:Biopsy; D004279:DNA, Viral / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D017403:In Situ Hybridization; D007577:JC Virus / Q000302:isolation & purification*; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D060888:Real-Time Polymerase Chain Reaction; D066027:Transplant Recipients; D014412:Tumor Virus Infections / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D014766:Viremia / Q000821:virology*
chemical_list: D000961:Antilymphocyte Serum; D004279:DNA, Viral; D007166:Immunosuppressive Agents
keywords: BK virus; JC virus; nephropathy; polyomavirus