Abu Jawdeh Bassam G, Smith Maxwell L, Hudson Madeline R, Mour Girish K, Budhiraja Pooja, Rosenthal Julie L
Division of Nephrology, Mayo Clinic Arizona, Phoenix, AZ, United States.
Division of Anatomic Pathology, Mayo Clinic Arizona, Phoenix, AZ, United States.
Front Med (Lausanne). 2023 Oct 20;10:1282827. doi: 10.3389/fmed.2023.1282827. eCollection 2023.
JC polyomavirus (JCPyV) is a ubiquitous virus that can be latent in the brain and the kidney. It is the etiologic agent responsible for progressive multifocal leukoencephalopathy, a fatal, demyelinating disease of the central nervous system, and rarely causes polyomavirus nephropathy in immunocompromised kidney transplant recipients.
We present the first case of JCPyV nephropathy in a simultaneous heart-kidney transplant patient, where viral-specific hybridization staining of the kidney tissue was utilized to confirm the diagnosis. The patient was diagnosed 6 years after simultaneous heart-kidney transplantation and was treated with immunosuppression reduction and intravenous immunoglobulin.
JCPyV nephropathy should be considered in the differential diagnosis of kidney allograft injury, particularly, with suggestive light microscopy histologic features in the absence of BK polyomavirus viremia and/or viruria. In addition to obtaining JCPyV PCR in the blood, hybridization staining may have a utility in confirming the diagnosis. To date, we lack effective JCPyV-specific therapies, and prompt initiation of immunosuppression reduction remains the mainstay of treatment.
JC多瘤病毒（JCPyV）是一种普遍存在的病毒，可潜伏在脑和肾脏中。它是导致进行性多灶性白质脑病的病原体，这是一种致命的中枢神经系统脱髓鞘疾病，在免疫功能低下的肾移植受者中很少引起多瘤病毒肾病。
我们报告了首例同时进行心脏-肾脏移植患者发生JCPyV肾病的病例，通过对肾脏组织进行病毒特异性杂交染色来确诊。该患者在同时进行心脏-肾脏移植6年后被诊断出患病，并接受了免疫抑制减量和静脉注射免疫球蛋白治疗。
在肾移植受者发生移植肾损伤的鉴别诊断中应考虑JCPyV肾病，特别是在没有BK多瘤病毒血症和/或病毒尿症且具有提示性光镜组织学特征的情况下。除了检测血液中的JCPyV PCR外，杂交染色可能有助于确诊。迄今为止，我们缺乏有效的JCPyV特异性治疗方法，迅速开始免疫抑制减量仍然是主要的治疗手段。
