Polyomavirus-associated nephropathy in renal and simultaneous pancreas-kidney transplant recipients: report of three cases.

Infection with polyomavirus (BK virus) is the cause of renal graft losses in more than 50% of the infected cases. There should be a high index of suspicion about this disease, although the incidence is only between 2% and 5% as the future of renal graft depends on the early and appropriate management of the same. Herein, we describe three clinical cases: Two were those of kidney transplant and the third, a combined kidney-pancreas transplant. In these cases, by reducing immunosuppression and, in one case, replacing the calcineurin inhibitor by MTOR (mammalian target of rapamycin) in addition, we were able to preserve of the normal function of the transplanted organs.

Polyomavirus-associated nephritis in 2 horses.

Polyomaviruses produce latent and asymptomatic infections in many species, but productive and lytic infections are rare. In immunocompromised humans, polyomaviruses can cause tubulointerstitial nephritis, demyelination, or meningoencephalitis in the central nervous system and interstitial pneumonia. This report describes 2 Standardbred horses with tubular necrosis and tubulointerstitial nephritis associated with productive equine polyomavirus infection that resembles BK polyomavirus nephropathy in immunocompromised humans.

Transient IgA nephropathy with acute kidney injury in a patient with dengue fever.

Dengue virus infection can clinically manifest as dengue fever, dengue shock syndrome and dengue hemorrhagic fever. Acute kidney injury as a result of dengue virus infection can occur due to various reasons including hypotension, rhabdomyolysis, sepsis and rarely immune complex mediated glomerular injury. However, glomerulonephritis associated with IgA Nephropathy in dengue virus infection has not been reported previously. We report a case of 15-year-old boy who was admitted with dengue fever and dialysis dependant acute kidney injury. Urine examination showed microscopic glomerular hematuria and proteinuria. Kidney biopsy showed mesangial proliferation with mesangial IgA dominant immune complex deposits and acute tubular necrosis. A repeated kidney biopsy 6 weeks after clinical recovery showed reversal of glomerular changes as well as resolution of mesangial IgA deposits.

Outbreak of common midwife toad virus in alpine newts (Mesotriton alpestris cyreni) and common midwife toads (Alytes obstetricans) in northern Spain: a comparative pathological study of an emerging ranavirus.

This report describes the isolation and characterisation of the common midwife toad virus (CMTV) from juvenile alpine newts (Mesotriton alpestris cyreni) and common midwife toad (CMT) tadpoles (Alytes obstetricans) in the Picos de Europa National Park in Northern Spain in August 2008. A comparative pathological and immunohistochemical study was carried out using anti-CMTV polyclonal serum. In the kidneys, glomeruli had the most severe histological lesions in CMT tadpoles, while both glomeruli and renal tubular epithelial cells exhibited foci of necrosis in juvenile alpine newts. Viral antigens were detected by immunohistochemical labelling mainly in the kidneys of CMT tadpoles and in ganglia of juvenile alpine newts. This is the first report of ranavirus infection in the alpine newt, the second known species to be affected by CMTV in the past 2 years.

[Acute necrotizing tubulointerstitial nephritis due to adenoviral infection following hematopoietic stem cell transplantation: clinical findings obtained from 4 autopsy cases].

Once adenovirus infection extends to the kidney from the bladder in the immunosuppressive state after hematopoietic stem cell transplantation, most patients develop acute renal failure due to adenovirus-associated necrotizing tubulointerstitial nephritis. In the 6 years from 2000 to 2006, we retrospectively investigated the characteristics of adenovirus infection in 402 patients who had received a hematopoietic stem cell transplantation in our hospital. The incidence of adenovirus-associated hemorrhagic cystitis in patients who had received a hematopoietic stem cell transplantation was 3.5% (14/402). Among these 14 patients, 4 developed acute necrotizing tubulointerstitial nephritis all of whom died, which yielded the incidence and mortality rates of the disease of 1.0% and 100%, respectively. Once adenovirus infection extends to major organs in a rapid manner, the patient's general condition becomes fatal. Further study is necessary to establish the diagnosis and treatment of adenoviral infections in a compromised host.