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CASE 18: Polyomavirus Nephropathy

Vanesa Bijol

  • 69-year-old man status post deceased donor kidney transplant for NSAIDs-related chronic tubulo-interstitial disease 10 months prior to current presentation. Azathioprine had to be discontinued due to pancytopenia. Corticosteroids were started. A biopsy was obtained to evaluate an elevated creatinine level.

  • Biopsy reveals extensive inflammation with frequent tubulitis (Figures 112-70 and 112-71). Some tubular epithelial cells reveal enlarged nuclei with viral inclusions. SV40 polyomavirus stain is positive in nuclei of infected cells by immunoperoxidase technique (Figure 112-72).

FIGURE 112-70
A micrograph highlights tubular cells.
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FIGURE 112-71
A micrograph shows a magnified view of tubular cells.
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FIGURE 112-72
A micrograph shows a magnified view of tubular cells. The nuclei are enlarged and viral particles are identified. SV40 IHC is noted in the micrograph.
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