Polyomavirus associated nephropathy after kidney and pancreas transplantation: case report

Gracin, Sonja and Kovačević Vojtušek, Ivana and Vidas, Željko and Knotek, Mladen and Kardum Skelin, Ika and Ljubanović, Danica (2010) Polyomavirus associated nephropathy after kidney and pancreas transplantation: case report. Collegium Antropologicum, 34 (2). pp. 623-6. ISSN 0350-6134

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Abstract

Polyomavirus virus associated nephropathy (PVAN) is an important cause of graft failure in the renal transplant population. The prevalence of PVAN has increased from 1% to 10% in the past decade, leading to loss of transplanted organ in 30% to 80% of cases. In the absence of specific antiviral drugs, early detection of disease and modification/reduction of immunosuppressive regimen is currently the cornerstone of therapy. In the setting of multiorgan transplantation, like simultaneous pancreas and kidney transplantation (SPKT), diagnosis and therapy of PVAN can be even more challenging problem. We report a first described case of PVAN in patient after SPKT in Croatia. Patient is a 32 years old Caucasian male with type 1 diabetes mellitus and end stage renal failure, diagnosed for PVAN 6 month after SPKT. Patient was treated with reduced immunosuppressive regimen. At 32 month follow up, patient has preserved kidney and pancreas function with estimated glomerular filtration (eGFR) rate of 91 mL/min and no signs of PVAN on his 2 year protocol kidney biopsy.

Abstract in Croatian

POLIOMAVIRUSOM UZROKOVANA NEFROPATIJA NAKON SIMULTANE TRANSPLANTACIJE BUBREGA I GUŠTERAČE – PRIKAZ SLUČAJA ----- Poliomavirusom uzrokovana nefropatija (PVAN) važan je uzrok disfunkcije i gubitka grafta bubrega nakon transplantacije. Prevalencija PVAN-a se povećala od 1% do 10% u posljednjih 10 godina i uzrokom je gubitka grafta bubrega u 30% do 80% slučajeva. Rana otkrivanje bolesti i modificiranje imunosupresivne terapije predstavljaju temelj liječenja. Specifična antiviralna terapija ne postoji. Dijagnostika i liječenje PVAN u bolesnika nakon multiorganske transplantacije, kao što je simultana transplantacija bubrega i gušterače (SPKT), predstavlja još veći izazov. Ovdje predstavljamo prvi opisani slučaj PVAN-a u bolesnika nakon SPKT u Hrvatskoj. Bolesnik je bio bijelac u dobi od 32 godine, koji boluje od tipa 1 šećerne bolesti i terminalne kronične bubrežne insuficijencije i koji je liječen simultanom transplantacijom bubrega i gušterače. PVAN je dijagnosticirana 6 mjeseci nakon SPKT. Liječen je smanjenjem doze trojne imunosupresivne terapije (takrolimus, mikofenolat mofetil i steroidi). Bolesnik ima očuvanu funkciju oba grafta nakon 32 mjeseca praćenja. Procijenjena glomerularna filtracija i znosi 91 mL/min bez znakova PVAN-a na protokol biopsiji bubrega nakon 2 godine.

Item Type: Article
MeSH: Epithelial Cells/pathology ; Epithelial Cells/virology ; Humans ; Immunohistochemistry ; Immunosuppressive Agents/blood ; Immunosuppressive Agents/therapeutic use ; Kidney Diseases/pathology ; Kidney Diseases/virology ; Kidney Transplantation/adverse effects ; Male ; Pancreas Transplantation/adverse effects ; Polyomavirus Infections/pathology ; Vacuoles/ultrastructure ; Young Adult
Departments: Katedra za internu medicinu
Katedra za patologiju
Depositing User: Marijan Šember
Status: Published
Creators:
CreatorsEmail
Gracin, SonjaUNSPECIFIED
Kovačević Vojtušek, IvanaUNSPECIFIED
Vidas, ŽeljkoUNSPECIFIED
Knotek, MladenUNSPECIFIED
Kardum Skelin, IkaUNSPECIFIED
Ljubanović, DanicaUNSPECIFIED
Date: June 2010
Date Deposited: 23 Nov 2010
Last Modified: 23 Sep 2011 16:11
Subjects: /
Related URLs:
    URI: http://medlib.mef.hr/id/eprint/894

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