TUBULOINTERSTITIAL VIRAL NEPHRITIS IN A RENAL ALLOGRAFT RECIPIENT (CASE REPORT)

Polyomavirüs, type BK is an important viral infection of the allograft kidney. Although BKV infected urethelial cell can be encountered frequently urinal infection, it is unlikely to found renal infection in renal allograft biopsies (RAB). In this study one renal transplant recipient with two RAB showed tubulointerstitial inflammation besides intranuclear inclusions and nuclear pleomorphism in tubular epithelial cells which characterized as tubulo-interstitial viral infection and the responsible agent was thought to be BKV primarily. Because pathological features persisted and acute rejection could not be excluded in the second RAB, antirejection therapy was administered and and a partial response was observed. Immunosupression was gradually reduced during the long follow up. At this period creatinine levels remained stable. Th RAB is a considered a golden standard in detecting dysfunctions in the allograft. Pathological features other than rejection can be observed in biopsies and they may overlap with viral infection and rejection findings. Epithelial intranuclear inclusions and nuclear polymorphism should remind the possibility of BKV nephropathy which is rarely seen.