Immunohistochemical features of BK virus nephropathy in renal transplant recipients

• Published in: Clinical transplantation Vol. 26; no. s24; pp. 20 - 24
• Main Authors: Yamanaka, Kazuaki, Oka, Kazumasa, Nakazawa, Shigeaki, Hirai, Toshiaki, Kishikawa, Hidefumi, Nishimura, Kenji, Kyo, Masahiro, Ichikawa, Yasuji
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Hoboken, NJ Blackwell Publishing Ltd 01.07.2012; Wiley
• Subjects: Adult; Biological and medical sciences; Biomarkers - metabolism; BK virus; BK Virus - pathogenicity; BK virus nephropathy; Collecting duct; Distal tubules; eosinophil; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Rejection; Hospitals; Humans; Immunoenzyme Techniques; immunohistochemical findings; Infectious diseases; Kidney Diseases - etiology; Kidney Diseases - metabolism; Kidney Diseases - pathology; Kidney Transplantation; Kidney Tubules - metabolism; Kidney Tubules - pathology; Kidney Tubules - virology; Leukocytes (eosinophilic); Male; Medical sciences; Middle Aged; Nephropathy; Polyomavirus Infections - complications; Polyomavirus Infections - metabolism; Polyomavirus Infections - virology; Renal function; renal transplantation; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Tissue, organ and graft immunology; Tubules; tubulitis; Tumor Virus Infections - complications; Tumor Virus Infections - metabolism; Tumor Virus Infections - virology; Viral diseases; Immunohistochemistry; renal transplantation; Granulocyte; Tubulopathy; Papovaviridae; Homotransplantation; Kidney; Surgery; Graft; BK virus nephropathy; immunohistochemical findings; Kidney disease; Opportunistic infection; Urinary system disease; Polyomavirus; BK virus; Eosinophil; Infection; Virus; Medicine; Anatomic pathology; Nephropathy; Treatment; Urinary system; tubulitis; Viral disease; Kidney transplantation
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/j.1399-0012.2012.01636.x

BK virus nephropathy (BKVN) is one of the factors that reduces renal graft function after transplantation. However, BKVN and rejection present similar pathological findings, as both are accompanied by cellular infiltration to the interstitium and tubulitis, thus they are difficult to distinguish for diagnosis and medical treatment. In the present study, we examined immunohistochemical pathological features of BKVN in four cases treated in our hospital from 2007 to 2010. Common immunohistological finding is that tubulitis in these cases was primarily EMA and 34βE12‐positive and existed predominantly from the collecting duct to the distal convoluted tubule. The majority of infected cells existed in EMA and 34βE12‐positive tubules, which were also located mainly from the collecting duct to the distal tubule. In addition, a large number of SV40‐positive infected cells were similarly seen. Dylon staining clearly revealed eosinophils. We concluded that the main pathological features of BKVN are the presence of tubulitis and infected cells predominantly from the collecting duct to distal tubule and the appearance of eosinophils.