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BK virus nephropathy after allogeneic stem cell transplantation: a case report and literature review.
- Source :
-
American journal of hematology [Am J Hematol] 2009 Apr; Vol. 84 (4), pp. 243-6. - Publication Year :
- 2009
-
Abstract
- Polyomaviruses are increasingly recognized as important human pathogens. Among those, BK virus has been identified as the main cause of polyomavirus-associated nephropathy (PVAN), a major cause of renal allograft failure. PVAN has also been well described in the setting of non-renal solid organ transplantation. The reports of PVAN after hematopoietic stem cell transplantation (HCT) are surprisingly very few. Here, we describe a patient with treatment-related myelodysplastic syndrome who received an unrelated donor HCT after ablative conditioning and in vivo T cell depletion with alemtuzumab. He developed a biopsy-proven BK nephropathy, which contributed to his renal failure. Leflunomide as well as cidofovir were given at different times, both in combination with intravenous immunoglobulin. Both treatments were effective in reducing the BK viral load, the cystitis symptoms and both stabilized but did not really improved the renal function. The patient was still dialysis-dependent when he died from Pseudomonas sepsis 13 months after HCT. A critical review of the literature and the treatment modalities for post-HCT PVAN are provided.<br /> (Copyright 2008 Wiley-Liss, Inc.)
- Subjects :
- Antiviral Agents therapeutic use
Cystitis etiology
Cystitis virology
Cytomegalovirus Infections complications
Fatal Outcome
Graft vs Host Disease complications
Hepatorenal Syndrome etiology
Humans
Immunoglobulins, Intravenous
Immunosuppressive Agents adverse effects
Immunosuppressive Agents therapeutic use
Kidney Failure, Chronic etiology
Kidney Failure, Chronic therapy
Lymphoma, Follicular complications
Lymphoma, Follicular drug therapy
Lymphoma, Follicular surgery
Male
Middle Aged
Myelodysplastic Syndromes etiology
Myelodysplastic Syndromes surgery
Nephritis, Interstitial virology
Polyomavirus Infections transmission
Postoperative Complications
Reoperation
Tacrolimus adverse effects
Transplantation Conditioning adverse effects
Transplantation, Autologous
BK Virus pathogenicity
Hematopoietic Stem Cell Transplantation adverse effects
Nephritis, Interstitial etiology
Polyomavirus Infections complications
Transplantation, Homologous adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1096-8652
- Volume :
- 84
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- American journal of hematology
- Publication Type :
- Academic Journal
- Accession number :
- 19208419
- Full Text :
- https://doi.org/10.1002/ajh.21358