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. 2025 Nov 3.
doi: 10.1007/s00467-025-07021-8. Online ahead of print.

BK virus nephropathy in a native kidney

Dermot Wildes #  1 , Davina Henderson #  2 , Sinéad Ryan  3 , Orla G Killeen  2 , Emma MacDermott  2 , Maria Stack  4 , Caoimhe Costigan  4
Affiliations

BK virus nephropathy in a native kidney

Dermot Wildes et al. Pediatr Nephrol. .

Abstract

Background: BK virus is a polyoma virus which has been associated with impaired graft function in kidney transplant recipients. After primary infection, the virus becomes latent in the renal/urinary epithelium. In immunocompetent hosts, there are usually no pathological sequelae.

Case: An 11-year-old female on chronic immunosuppression for a severe auto-immune/inflammatory condition was referred to Paediatric Nephrology due to a persistently elevated serum creatinine. Extensive investigation yielded BK viruria and viraemia. Kidney biopsy showed multifocal lymphocytic tubulitis, with cytonuclear changes. Immunohistochemical staining for SV40 was positive, and a diagnosis of native kidney BK virus nephropathy was made.

Conclusion: We present the first non-malignancy/transplant-associated paediatric case of BK virus nephropathy in a native kidney. In an era of increasing use of immunosuppressive medicines for a variety of indications, clinicians should include BK virus infection in their differential diagnosis for nephropathy in patients on chronic, high-dose immunosuppression.

Keywords: BK polyoma virus; BK virus nephropathy; Native kidney.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests. Patient consent: The patient has consented to the use of their data in this publication.

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