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JC多瘤病毒肾病:肾移植术后晚期的一种罕见并发症。

JC Polyomavirus Nephropathy: A Rare Complication Late after Kidney Transplantation.

作者信息

Gerber Jennifer Scotti, De Marchi Sara, Gaspert Ariana, Fehr Thomas, Cippà Pietro E

机构信息

Division of Nephrology, Ente Ospedaliero Cantonale, Lugano, Switzerland.

Faculty of Biomedical Science, Università della Svizzera Italiana, Lugano, Switzerland.

出版信息

Case Rep Nephrol Dial. 2024 Aug 29;14(1):148-157. doi: 10.1159/000540294. eCollection 2024 Jan-Dec.

Abstract

INTRODUCTION

JC-polyomavirus-associated nephropathy (JC-PVAN) is a rare cause of allograft dysfunction with only a few cases described in the literature.

CASE PRESENTATION

We present 2 cases of JC-PVAN, both of which occurred >5 years after kidney transplantation. In both cases, transplant biopsies were performed because of worsening of kidney function. We found tubulitis and interstitial inflammation; immunohistochemistry was positive for SV40, but BK virus was not detected. The presence of JC virus confirmed the diagnosis of JC-PVAN. Immunosuppressive therapy was adopted, but in both cases graft function progressively deteriorated.

CONCLUSIONS

Our cases show that JC-PVAN, although much rarer than BK-PVAN, should be considered a possible cause of graft dysfunction even years after transplantation. Complete diagnostic workup, including kidney biopsy, is crucial for correct diagnosis and treatment.

摘要

引言

JC多瘤病毒相关性肾病(JC-PVAN)是同种异体移植功能障碍的罕见原因,文献中仅描述了少数病例。

病例报告

我们报告2例JC-PVAN,均发生在肾移植5年之后。两例均因肾功能恶化而行移植肾活检。我们发现了肾小管炎和间质炎症;免疫组化显示SV40呈阳性,但未检测到BK病毒。JC病毒的存在证实了JC-PVAN的诊断。采用了免疫抑制治疗,但两例移植肾功能均逐渐恶化。

结论

我们的病例表明,JC-PVAN虽然比BK-PVAN罕见得多,但即使在移植多年后也应被视为移植功能障碍的可能原因。完整的诊断检查,包括肾活检,对于正确的诊断和治疗至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbe7/11521426/7203e6022c63/cnd-2024-0014-0001-540294_F01.jpg

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