Polyomavirus-induced interstitial nephritis in two renal transplant recipients: case reports and review of the literature

• Published in: American journal of kidney diseases Vol. 29; no. 5; p. 754
• Main Authors: Mathur, V S, Olson, J L, Darragh, T M, Yen, T S
• Format: Journal Article
• Language: English
• Published: United States 01.05.1997
• Subjects: Acute Disease; Adult; Biopsy; Cadaver; Female; Humans; Kidney - ultrastructure; Kidney - virology; Kidney Transplantation - pathology; Male; Nephritis, Interstitial - etiology; Nephritis, Interstitial - pathology; Nephritis, Interstitial - virology; Polyomavirus; Polyomavirus Infections - complications; Polyomavirus Infections - pathology; Polyomavirus Infections - virology; Postoperative Complications - etiology; Postoperative Complications - pathology; Postoperative Complications - virology; Tumor Virus Infections - complications; Tumor Virus Infections - pathology; Tumor Virus Infections - virology
• ISSN: 0272-6386

We present two case reports of renal polyomavirus infection leading to renal allograft dysfunction, review the literature of this entity, and discuss the role of specific immunosupressives. Histologically, the virus caused an interstitial infiltrate composed of plasma cells and lymphocytes, interstitial fibrosis, and tubular atrophy. Viral inclusions were seen within tubular cells on light microscopy. Electron microscopy showed viral particles of 40 to 50 nm in a characteristic paracrystalline array. Both patients had been on FK-506-based immunosuppression. In both patients, the virus appeared to clear histologically and renal function stabilized when the patients were converted to cyclosporine-based immunosuppression. Contrary to prior reports, our patients have not lost their grafts and continue to have stable, albeit reduced, graft function at 2.5 years and 4.5 years following the initial diagnosis of renal polyomavirus infection.