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NDT Advance Access originally published online on June 2, 2007
Nephrology Dialysis Transplantation 2007 22(8):2386-2390; doi:10.1093/ndt/gfm283
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Transient allograft dysfunction from immune reconstitution in a patient with polyoma BK-virus-associated nephropathy

Stefan Schaub1, Michael Mayr1, Adrian Egli2, Simone Binggeli2, Bernard Descœudres1, Jürg Steiger1, Michael J. Mihatsch3 and Hans H. Hirsch2,4

1Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, 2Transplantation Virology and Molecular Diagnostics, Department of Clinical and Biological Sciences, Institute for Medical Microbiology, University of Basel, 3Institute for Pathology, University Hospital Basel and 4Clinic for Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland

Correspondence and offprint requests to: Stefan Schaub, MD, MSc, Transplantation Immunology and Nephrology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland. Email: schaubs@uhbs.ch

Keywords: immune reconstitution syndrome; polyoma BK-virus nephropathy; renal allograft rejection

The first 150 words of the full text of this article appear below.



   Introduction
 
During the last 10 years, polyoma BK-virus associated nephropathy (PVAN) has emerged as a serious complication in renal transplant recipients [1]. Due to the establishment of an accurate non-invasive screening procedure measuring polyomavirus BK-viraemia, BK-viruria and decoy cells in urine, PVAN can be diagnosed at early stages [2]. This allows for timely therapeutic intervention, which has significantly reduced the incidence of severe PVAN courses including graft loss [3,4].

Management of PVAN is mainly based on a reduction of the immunosuppressive drugs, while the impact of anti-viral therapy is not yet clear [5]. This strategy bears the inherent risk that allograft rejection may arise, which is difficult to differentiate from an immune response to the BK-virus, because both entities can present as morphologically and molecularly indistinguishable, with interstitial infiltrates and tubulitis [1,5–7,]. Therefore, more data regarding the . . . [Full Text of this Article]



   Case report
 


   Discussion
 

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