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Case Reports
. 2024 Aug 29;14(1):148-157.
doi: 10.1159/000540294. eCollection 2024 Jan-Dec.

JC Polyomavirus Nephropathy: A Rare Complication Late after Kidney Transplantation

Jennifer Scotti Gerber  1   2 , Sara De Marchi  1 , Ariana Gaspert  3 , Thomas Fehr  4   5 , Pietro E Cippà  1   2
Affiliations
Case Reports

JC Polyomavirus Nephropathy: A Rare Complication Late after Kidney Transplantation

Jennifer Scotti Gerber et al. Case Rep Nephrol Dial. .

Abstract

Introduction: JC-polyomavirus-associated nephropathy (JC-PVAN) is a rare cause of allograft dysfunction with only a few cases described in the literature.

Case presentation: We present 2 cases of JC-PVAN, both of which occurred >5 years after kidney transplantation. In both cases, transplant biopsies were performed because of worsening of kidney function. We found tubulitis and interstitial inflammation; immunohistochemistry was positive for SV40, but BK virus was not detected. The presence of JC virus confirmed the diagnosis of JC-PVAN. Immunosuppressive therapy was adopted, but in both cases graft function progressively deteriorated.

Conclusions: Our cases show that JC-PVAN, although much rarer than BK-PVAN, should be considered a possible cause of graft dysfunction even years after transplantation. Complete diagnostic workup, including kidney biopsy, is crucial for correct diagnosis and treatment.

Keywords: BK virus; Infection; JC virus; Kidney transplantation; Polyoma nephropathy.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
a PV nephropathy with focal interstitial mononuclear infiltrates (HE, original magnification ×50). Inset: positive staining for PV in multiple tubular epithelial cells (SV40 immunohistochemistry, original magnification ×120). b, c Tubules with intranuclear inclusions typical for PV (HE, original magnification ×400 in B and ×200 in C). d Positive staining for PV in multiple tubular epithelial cells (SV40 immunohistochemistry, original magnification ×250).
Fig. 2.
Fig. 2.
Time course of creatinine level and medication of patients 1 and 2.
Fig. 3.
Fig. 3.
a PV nephropathy with focal interstitial mononuclear infiltrates (HE, original magnification ×60). Inset: positive staining for PV in multiple tubular epithelial cells (SV40 immunohistochemistry, original magnification ×50). b–d Tubules with intranuclear inclusions typical for PV (HE, original magnification ×280 in b and c, ×250 in d). Inset in (d): positive staining for PV in multiple tubular epithelial cells (SV40 immunohistochemistry, original magnification ×180).
See this image and copyright information in PMC

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