The Department of Urology, Hyogo Prefectural Nishinomiya Hospital, Osaka, Japan.
Clin Transplant. 2012 Jul;26 Suppl 24:20-4. 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.
BK 病毒肾病(BKVN)是移植后降低肾移植物功能的因素之一。然而,BKVN 和排斥反应具有相似的病理表现,两者均伴有细胞浸润到间质和肾小管炎,因此难以进行诊断和治疗。在本研究中,我们检查了 2007 年至 2010 年在我院治疗的 4 例 BKVN 的免疫组织化学病理特征。常见的免疫组织学发现是,这些病例的肾小管炎主要是 EMA 和 34βE12 阳性,主要存在于集合管到远曲小管。大多数感染细胞存在于 EMA 和 34βE12 阳性的小管中,主要位于集合管到远曲小管。此外,还可见大量 SV40 阳性感染细胞。Dylon 染色清晰显示嗜酸性粒细胞。我们得出结论,BKVN 的主要病理特征是存在主要位于集合管到远曲小管的肾小管炎和感染细胞,以及嗜酸性粒细胞的出现。