Pathology of resolving polyomavirus-associated nephropathy.

摘要: Control of polyomavirus BK (BKV) is achieved by reducing immunosuppression allowing an effective BKV-specific T-cell response. The morphology resolving BKV-associated nephropathy (PyVAN) has not been systematically investigated. Ninety-nine surveillance biopsies 35 patients with BKV viremia treated exclusively reduction were scored according to Banff criteria and grouped relative as pre-, increasing, decreasing post-BKV viremia. Thirty-four (97%) cleared after a median 9 months posttransplantation. tubulitis score, extent tubules intraepithelial lymphocytes, interstitial inflammation significantly increased from the time increasing Tubulointerstitial inflammation, lower extent, persisted clearance. number SV40+ correlated load in plasma, but SV40 immunohistochemistry was frequently negative (60%). During viremia, 31% PyVAN cases plasma cell-rich 40% showed tubular HLA-DR expression. Compared baseline 1 month posttransplantation, allograft function remained stable or improved 29/35 (83%) follow-up 48 months. Within year clearance clinical rejection occurred 2/35 (6%). Our data suggest that typically characterized self-limiting acute nephritis, morphologically indistinguishable rejection.