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Official publication of the Indian Society of Nephrology
 
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Glomerulonephritis with crescents in polyomavirus nephropathy


1 Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
3 Department of Renal Transplant Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Aravind Sekar,
Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.ijn_336_21

Polyomavirus nephropathy (PVN) is a known complication of renal transplantation due to the reactivation of latent BK virus (BKV) infection. Viral replication is usually confined to tubules. However, in severe viremia and late stages of PVN, it can involve glomerular parietal epithelial cells. Glomerular involvement by BKV can cause crescent formation and may lead to graft failure. We describe a relatively rare case of PVN with glomerular involvement and crescent formation in a 52-year-old male who had undergone a transplant 16 months ago. Despite the stoppage of immunosuppression, graft failure occurred eventually. Interestingly, we observed the intense positivity for IgG and c4d in the Bowman capsule on immunofluorescence. Observation of such positivity along Bowman capsule in renal biopsies with a limited number of glomeruli should alert pathologists to do a vigilant search of BKV inclusion and perform immunohistochemistry for SV 40 large T antigen.


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Indian Journal of Nephrology
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Online since 20th Sept '07