J Korean Soc Transplant.  1998 Nov;12(2):313-318.

Polyomavirus Induced Interstital Nephritis in Renal Allograft Recipient

• Moon JI
• Jeong HJ
• Hong SW
• Cho NS
• Kim SI
• Kim YS
• Park K

Abstract

We report our experience of renal polyomavirus infection after renal allograft leading to graft dysfunction. A fourty seven-years-old male patient, has been on Tacrolimus based dual immunosuppression, showed graft dysfunction with rising serum creatinine at post-transplant day 140. His graft function had been good without any acute rejection episode. A tentative diagnosis of acute rejection was rendered and core needle biopsy was performed. Viral infection was initially suggested by the occurrence of markedly enlarged tubular epithelial cells containing large nuclei with smudgy chromatin pattern. Confirmatory diagnosis of human polyomavirus induced interstitial nephritis was obtained by electron microscopy, which showed viral particles in the nuclei of tubular epithelial cells. After Tacrolimus was converted to cyclosporine, renal function was stabilized. A review of the literature indicates that asymptomatic infection, ureteric stricture, and hemorrhagic cystitis are other possible manifestations of polyomavirus in the human urogenital tract. According to some prior reports, polyomavirus induced interstitial nephritis might be a cause of graft loss. But our patient has retained a stable graft function with a chnange of immunosuppression.

Keyword

Renal allograft; Polyomavirus; Graft dysfunction; Interstitial nephritis

MeSH Terms

Allografts*
Asymptomatic Infections
Biopsy, Large-Core Needle
Chromatin
Constriction, Pathologic
Creatinine
Cyclosporine
Cystitis
Diagnosis
Epithelial Cells
Humans
Immunosuppression
Male
Microscopy, Electron
Nephritis*
Nephritis, Interstitial
Polyomavirus Infections
Polyomavirus*
Tacrolimus
Transplants
Ureter
Virion
Chromatin
Creatinine
Cyclosporine
Tacrolimus