Abstract
BK DNAemia in renal transplant recipients is a significant cause of allograft dysfunction and can lead to graft loss due to BK polyomavirus-associated nephropathy or to graft rejection due to immunosuppression reduction. Currently, the first-line treatment for BK DNAemia is immunosuppression reduction. Second-line treatment for BK DNAemia has not been well-established. In this report, we present a case of a highly sensitized second-time pediatric renal transplant recipient with severe and persistent BK DNAemia and rising DSA, who was treated with IVIG and subsequently found to have clearance of BK viremia with concomitant reduction in DSA.
Keywords:
BK virus; donor-specific antibodies; immunosuppression; intravenous immunoglobulin; pediatric renal transplant; sensitized.
© 2019 Wiley Periodicals, Inc.
MeSH terms
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BK Virus* / genetics
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BK Virus* / isolation & purification
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Biomarkers / blood
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Child
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DNA, Viral / blood
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Humans
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Immunocompromised Host
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Immunoglobulins, Intravenous / therapeutic use*
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Immunologic Factors / therapeutic use*
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Isoantibodies / blood
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Kidney Transplantation*
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Male
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Polyomavirus Infections / diagnosis
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Polyomavirus Infections / drug therapy*
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Polyomavirus Infections / etiology
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Polyomavirus Infections / immunology
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Postoperative Complications / diagnosis
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Postoperative Complications / drug therapy*
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Postoperative Complications / immunology
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Tumor Virus Infections / diagnosis
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Tumor Virus Infections / drug therapy*
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Tumor Virus Infections / etiology
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Tumor Virus Infections / immunology
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Viral Load
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Viremia / diagnosis
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Viremia / drug therapy
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Viremia / etiology
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Viremia / immunology
Substances
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Biomarkers
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DNA, Viral
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Immunoglobulins, Intravenous
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Immunologic Factors
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Isoantibodies