Department of Pharmacy, University of Wisconsin Hospital and Clinics, Madison, WI, USA.
Division of Nephrology, Department of Internal Medicine, University of Wisconsin School of Medicine and Public Health Madison, WI, USA.
Transpl Infect Dis. 2020 Oct;22(5):e13316. doi: 10.1111/tid.13316. Epub 2020 May 21.
There is minimal literature describing the clinical workup of patients with persistent BKPyV-DNAemia despite aggressive immunosuppressive reduction. We present a case herein of persistent BKPyV-DNAemia with significant discordance of BK viruria level in a kidney transplant recipient found to have bladder carcinoma. Based on our findings, we recommend evaluating the urine of patients with persistent BKPyV-DNAemia for BK viruria. If there is significant discordance in the level of BKPyV-DNAemia and viruria, cystoscopy should be pursued to rule out bladder or uroepithelial malignancies.
目前文献对于持续存在 BK 多瘤病毒(BKPyV)-DNA 血症但接受强化免疫抑制治疗后病毒载量仍未降低的患者的临床评估描述较少。本文报道了 1 例肾移植后持续 BKPyV-DNA 血症合并 BK 病毒尿症水平显著不一致的患者,该患者后确诊膀胱癌。根据我们的发现,建议对持续 BKPyV-DNA 血症患者的尿液进行 BK 病毒尿症检测。如果 BKPyV-DNA 血症和病毒尿症水平存在显著差异,应进行膀胱镜检查以排除膀胱或尿路上皮恶性肿瘤。