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Native kidney BK virus nephropathy associated with acute lymphocytic leukemia

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Abstract

Background

Polyoma BK virus nephropathy is a common complication after renal transplantation and is rarely seen in non-renal transplant recipients. There are only a couple of case reports of BK virus nephropathy in native kidneys in non-transplant patients, including a recent report of a 73-year-old patient with chronic lymphatic leukemia. A variety of treatment options, including leflunomide and cidofovir, were reported in these patients.

Case diagnosis/treatment

Here we report the case of a 10-year-old boy with acute lymphatic leukemia who presented with non-oliguric hypertensive acute kidney injury at the 12th maintenance cycle of his chemotherapy. The workup supported the clear diagnosis of BK virus nephropathy with tubulointerstitial changes, and the patient responded favorably to intravenous immunoglobulin therapy.

Conclusions

Pediatric nephrologists need to consider BK virus nephropathy as a differential diagnosis of acute kidney injury in immunocompromised non-transplant patients.

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Notes

  1. Phase III Randomized Study of Different Combination Chemotherapy Regimens in Pediatric Patients With Newly Diagnosed Standard-Risk B-Precursor Acute Lymphoblastic Leukemia. All patients receive cytarabine intrathecally (IT) on day 1; vincristine intravenously (IV) on days 1, 8, 15, and 22; dexamethasone IV or orally twice daily on days 1–28; pegaspargase intramuscularly (IM) (may give IV over 1–2 h) on day 4, 5, or 6; methotrexate IT on days 8 and 29 (and days 15 and 22 for patients with CNS3 disease.

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Authors and Affiliations

  1. Department of Pathology & Laboratory Medicine, London Health Science Centre—University of Western Ontario, London, ON, Canada

    Guido Filler & Aaron Haig

  2. Department of Pediatrics, Division of Nephrology, Children’s Hospital, London Health Science Centre—University of Western Ontario, 800 Commissioners Road East, London, ON, Canada, N6A 5W9

    Guido Filler

  3. Division of Nephrology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada

    Christoph Licht

Authors
  1. Guido Filler
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  2. Christoph Licht
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  3. Aaron Haig
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Correspondence to Guido Filler.

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Filler, G., Licht, C. & Haig, A. Native kidney BK virus nephropathy associated with acute lymphocytic leukemia. Pediatr Nephrol 28, 979–981 (2013). https://doi.org/10.1007/s00467-013-2438-3

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  • DOI: https://doi.org/10.1007/s00467-013-2438-3

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