| Title: | Case report: Late-onset BK polyomavirus-associated nephropathy in kidney transplant recipients : two cases and insights into underlying mechanisms |
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| Authors: | ID Belčič Mikič, Tanja (Author)
ID Bošnjak, Matic (Author)
ID Arnol, Miha (Author) |
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| Files: |  PDF - Presentation file, download (765,74 KB)
MD5: B2281CA276D29F6FD4C40AB45721CA9C
 URL - Source URL, visit https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1799421/full
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| Language: | English |
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| Typology: | 1.03 - Other scientific articles |
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| Organization: |  UKC LJ - Ljubljana University Medical Centre
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| Abstract: | BK polyomavirus–associated nephropathy (BKPyVAN) results from primary infection or reactivation of BK polyomavirus (BKPyV) and remains a significant complication in kidney transplant recipients, contributing to allograft dysfunction and premature allograft loss. Most cases occur within the first 2 years post-transplant, when cell-mediated immunity is most suppressed due to induction immunosuppression. Here, we describe two unusual cases of late-onset BKPyVAN occurring in the absence of intensified immunosuppression and provide a review of potential mechanisms underlying its development in kidney transplant recipients. In the first patient, BKPyVAN developed 9 years after transplantation during maintenance dual immunosuppression with tacrolimus and mycophenolic acid, without prior rejection episodes or exposure to intensified immunosuppression. In the second patient, BKPyVAN first occurred 3 years post-transplant in the setting of concomitant cytomegalovirus colitis, also during dual immunosuppression with tacrolimus and mycophenolic acid. Despite reduction of immunosuppression, BKPyVAN persisted at 1-year follow-up and was associated with a gradual decline in allograft function. These cases highlight that late-onset BKPyVAN may develop even without intensified immunosuppression and can lead to significant allograft injury. Improved strategies are needed to identify patients at risk for late-onset BKPyVAN and to optimize therapeutic management. |
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| Keywords: | BK polyomavirus-associated nephropathy, diagnosis, immunosuppression, kidney transplantation, pathophysiology |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2026 |
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| Number of pages: | Str. 1-9 |
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| Numbering: | Vol. 13, [article no.] 1799421 |
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| PID: | 20.500.12556/DiRROS-30848  |
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| UDC: | 616.61 |
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| ISSN on article: | 2296-858X |
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| DOI: | 10.3389/fmed.2026.1799421 |
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| COBISS.SI-ID: | 283840515 |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 7. 7. 2026;
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| Publication date in DiRROS: | 07.07.2026 |
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| Views: | 161 |
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| Downloads: | 99 |
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