Author(s): Barreto,Patrícia ; Almeida,Manuela ; Dias,Leonídio ; Vieira,Pedro ; Pedroso,Sofia ; Martins,La Salete ; Henriques,António Castro ; Cabrita,António
Date: 2016
Origin: SciELO Portugal
Subject(s): Atypical presentation; BK virus; early diagnosis; kidney transplant; nephritis; therapeutic interventions
Over the last 15 years, better immunosuppressive drugs have decreased acute rejection rates in kidney transplantation but have also led to an increase in the incidence and impact of BK virus nephropathy. The authors report the case of a 62--year-old man submitted to a renal transplant of a deceased donor with an immunosuppression regimen free of rabbit anti -thymocyte globulin and tacrolimus, in whom BK nephropathy was diagnosed at seven weeks post-transplant. Intravenous human immunoglobulin (IVIG) was administered after immunosuppression reduction. Instituted treatment was successful. This clinical case highlights the importance of a high index of suspicion for an atypical presentation of BK nephropathy in renal transplant recipients and strengthens the need for other therapeutic interventions beyond the reduction of immunosuppression. It was the starting point for a review of BK virus nephropathy in kidney transplantation with a focus on risk factors, diagnosis and treatment
