QJM Advance Access originally published online on April 29, 2008
QJM 2008 101(7):594-598; doi:10.1093/qjmed/hcn051
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© The Author 2008. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Obstruction or renal allograft rejection—potential clinical markers of BK virus nephropathy
| The first 150 words of the full text of this article appear below. |
Sir,
BK virus (BKV)-associated nephropathy in renal transplant recipients is an emerging cause of allograft dysfunction and transplant loss.1,2 BKV is a human polyomavirus which is a member of the Papovaviridae family. These are non-enveloped viruses of small virion size with a closed, circular double DNA-stranded genome.3 Polyomaviruses are ubiquitous in nature and were first isolated from the urine of a renal transplant patient who developed ureteral stenosis post-operatively.3 Up to 80% of adults are seropositive for BKV with the virus subsequently remaining dormant in the uroepithelium. The majority of primary infections are asymptomatic or minimally symptomatic. The incidence of BKV nephropathy among renal transplant recipients is as high as 5%.1 The majority of infections occur within the first 3 months after transplant; however, infections occurring >2 years after transplantation have been reported.4 BKV disease is associated with haemorrhagic and non-haemorrhagic cystitis, ureteric stenosis and tubulointerstitial nephritis.4 Between 30% and
Cases
Case 1
Case 2
Discussion
Department of Renal Medicine
Consultant Nephrologist/Honorary Clinical Reader
Hull and East Yorkshire Hospitals
NHS Trust and Hull York Medical School
email: Sunil.bhandari@hey.nhs.uk
Department of Pathology
Hull and East Yorkshire Hospitals NHS Trust
Hull Royal Infirmary
Kingston upon Hull
HU32JZ, UK