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Soichi Matsumura,1 Taigo Kato,1,2 Ayumu Taniguchi,1 Masataka Kawamura,1 Shigeaki Nakazawa,1 Tomoko Namba-Hamano,3 Toyofumi Abe,1 Norio Nonomura,1 Ryoichi Imamura1
1Division of Urology, Osaka College Graduate College of Drugs, Osaka 565-0871, Japan; 2Division of Urological Immuno-Oncology, Osaka College Graduate College of Drugs, Osaka 565-0871, Japan; 3Division of Nephrology, Osaka College Graduate College of Drugs, Osaka 565-0871, Japan
Correspondence: Taigo Kato
Division of Urology, Osaka College Graduate College of Drugs, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
E mail firstname.lastname@example.org
Goal: BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN) is without doubt one of the most tough infections to be handled after kidney transplantation. Though sufferers with BKPyVAN normally acquired a discount of immunosuppressive brokers, nearly all of these sufferers endure the lack of the graft kidney with none efficient remedy afterward. Due to this fact, growth of more practical remedy for BKPyVAN is eagerly anticipated.
Sufferers and Strategies: Amongst sufferers who underwent a kidney transplantation between January 2016 and April 2019 at our hospital, there have been 5 instances of BKPyVAN. After the preliminary prognosis, all sufferers discontinued administration of mycophenolate mofetil (MMF), which was not sufficient to decrease decoy cells in urine cytology check. Due to this fact, all sufferers acquired extra intravenous immunoglobulin (IVIG) (100 mg/kg/day) remedy for 5 days and have been evaluated for the therapeutic impact of IVIG with immunohistochemical examination utilizing re-biopsy samples of the graft kidney.
Outcomes: After IVIG remedy, 2 instances confirmed unfavorable decoy cells in urine and three instances confirmed a drastic lower of plasma BK virus load. Importantly, simian virus (SV) 40 giant T antigens diminished after IVIG administration in all instances, which degraded polyomavirus nephropathy classification.
Conclusion: Though it’s tough to deal with BKPyVAN after kidney transplant, IVIG remedy was thought of to a promising remedy to enhance severity of BKPyVAN particularly in instances that dose discount of immunosuppressive brokers was ineffective.
Key phrases: BK virus, BK virus nephropathy, intravenous immunoglobulin; IVIG, kidney transplantation, polyomavirus nephropathy classification
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