Polyoma virus infection after renal transplantation: Use of immunostaining as a guide to diagnosis

Polyoma virus infection is characterized by lymphocytic interstitial infiltrate in the kidney, and it mimics acute rejection. The purpose of this study is to estimate renal allograft outcome with this infection and characterize the lymphocytic infiltrates in polyoma virus-infected renal allografts....

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Veröffentlicht in:Transplantation 2001-04, Vol.71 (7), p.896-899
Hauptverfasser: AHUJA, Manohar, COHEN, Eric P, DAYER, Ann M, KAMPALATH, Bal, CHANG, Chung-Che, BRESNAHAN, Barbara A, HARIHARAN, Sundaram
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container_end_page 899
container_issue 7
container_start_page 896
container_title Transplantation
container_volume 71
creator AHUJA, Manohar
COHEN, Eric P
DAYER, Ann M
KAMPALATH, Bal
CHANG, Chung-Che
BRESNAHAN, Barbara A
HARIHARAN, Sundaram
description Polyoma virus infection is characterized by lymphocytic interstitial infiltrate in the kidney, and it mimics acute rejection. The purpose of this study is to estimate renal allograft outcome with this infection and characterize the lymphocytic infiltrates in polyoma virus-infected renal allografts. Patients who had polyoma virus inclusions in renal allograft biopsies were identified. Other viral inclusions were excluded by immunohistochemistry. The lymphocytic infiltrates of six cases of polyoma virus infection were compared with six cases of definite acute rejection by immunostaining for T and B cells. There were 10 cases of polyoma virus infections in renal transplant recipients. Immunosuppressants consisted of mycophenolate mofetil with tacrolimus in eight cases and mycophenolate mofetil with cyclosporine in two. The median time of diagnosis of polyoma virus infection after transplantation was 9.5 months, and the time to graft failure after the diagnosis was 4 months. Reduced allograft survival was seen in patients who had polyoma virus infection. Immunostaining for T and B cells revealed marked increase in the B cells (CD20) in renal allografts with polyoma virus infection of 21% (range, 5-40%) compared with 6% (range, 0-10%) in those with acute rejection (P=0.039). Reduced cytotoxic T cells (TIA-1: median, 7%; range, 2-15%) were seen in polyoma virus-infected allografts compared with 24% (range, 15-30%) in those patients who had acute rejection (P=0.0159). Irreversible graft failure is more prevalent with polyoma virus infection. Enhanced immunosuppressants with mycophenolate mofetil with tacrolimus may play a role in the development of this infection. An increase in CD20 and a decrease in cytotoxic T cells in allografts is characteristic of polyoma virus infection.
doi_str_mv 10.1097/00007890-200104150-00013
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The purpose of this study is to estimate renal allograft outcome with this infection and characterize the lymphocytic infiltrates in polyoma virus-infected renal allografts. Patients who had polyoma virus inclusions in renal allograft biopsies were identified. Other viral inclusions were excluded by immunohistochemistry. The lymphocytic infiltrates of six cases of polyoma virus infection were compared with six cases of definite acute rejection by immunostaining for T and B cells. There were 10 cases of polyoma virus infections in renal transplant recipients. Immunosuppressants consisted of mycophenolate mofetil with tacrolimus in eight cases and mycophenolate mofetil with cyclosporine in two. The median time of diagnosis of polyoma virus infection after transplantation was 9.5 months, and the time to graft failure after the diagnosis was 4 months. Reduced allograft survival was seen in patients who had polyoma virus infection. Immunostaining for T and B cells revealed marked increase in the B cells (CD20) in renal allografts with polyoma virus infection of 21% (range, 5-40%) compared with 6% (range, 0-10%) in those with acute rejection (P=0.039). Reduced cytotoxic T cells (TIA-1: median, 7%; range, 2-15%) were seen in polyoma virus-infected allografts compared with 24% (range, 15-30%) in those patients who had acute rejection (P=0.0159). Irreversible graft failure is more prevalent with polyoma virus infection. Enhanced immunosuppressants with mycophenolate mofetil with tacrolimus may play a role in the development of this infection. 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Transplantations, organ and tissue grafts. 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Immunostaining for T and B cells revealed marked increase in the B cells (CD20) in renal allografts with polyoma virus infection of 21% (range, 5-40%) compared with 6% (range, 0-10%) in those with acute rejection (P=0.039). Reduced cytotoxic T cells (TIA-1: median, 7%; range, 2-15%) were seen in polyoma virus-infected allografts compared with 24% (range, 15-30%) in those patients who had acute rejection (P=0.0159). Irreversible graft failure is more prevalent with polyoma virus infection. Enhanced immunosuppressants with mycophenolate mofetil with tacrolimus may play a role in the development of this infection. An increase in CD20 and a decrease in cytotoxic T cells in allografts is characteristic of polyoma virus infection.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Antigens, CD20 - analysis</subject><subject>B-Lymphocytes - pathology</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Graft Rejection - pathology</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Immunohistochemistry - methods</subject><subject>Immunosuppressive Agents - adverse effects</subject><subject>Kidney - pathology</subject><subject>Kidney Transplantation</subject><subject>Lymphocyte Count</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mycophenolic Acid - adverse effects</subject><subject>Mycophenolic Acid - analogs &amp; derivatives</subject><subject>Papillomavirus Infections - chemically induced</subject><subject>Papillomavirus Infections - diagnosis</subject><subject>Papillomavirus Infections - immunology</subject><subject>Papillomavirus Infections - pathology</subject><subject>Polyomavirus</subject><subject>Staining and Labeling</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>T-Lymphocytes, Cytotoxic - pathology</subject><subject>Tacrolimus - adverse effects</subject><subject>Tumor Virus Infections - chemically induced</subject><subject>Tumor Virus Infections - diagnosis</subject><subject>Tumor Virus Infections - immunology</subject><subject>Tumor Virus Infections - pathology</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkE1LxDAQhoMo7rr6FyQH8VbNR9s03mTxCxb04J6XaTpZsrTJ2qSC_96IKziXgXkfZt53CKGc3XCm1S3LpRrNCsEYZyWvWJEnXB6ROa9kWdSsYcdkzrJUcCnVjJzFuMtIJZU6JTPOZamVkHPSvoX-KwxAP904Req8RZNc8BRswpGO6KGnaQQf9z34BD_aHV1HpMFSNwyTDzGB885vKUQKdDu5DmkKtHOwzaKL5-TEQh_x4tAXZP348L58LlavTy_L-1Wxk7VIRT5cWrSatx1WBjuDOQlra6FNpWprmakbg7ZTFVe21qCNaEHUUklhS8jwglz_7t2P4WPCmDaDiwb77BvDFDdcNU2jhcrg5QGc2gG7zX50A4xfm7-vZODqAEA00Nsc37j4n8sehPwGExV0rg</recordid><startdate>20010415</startdate><enddate>20010415</enddate><creator>AHUJA, Manohar</creator><creator>COHEN, Eric P</creator><creator>DAYER, Ann M</creator><creator>KAMPALATH, Bal</creator><creator>CHANG, Chung-Che</creator><creator>BRESNAHAN, Barbara A</creator><creator>HARIHARAN, Sundaram</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope></search><sort><creationdate>20010415</creationdate><title>Polyoma virus infection after renal transplantation: Use of immunostaining as a guide to diagnosis</title><author>AHUJA, Manohar ; COHEN, Eric P ; DAYER, Ann M ; KAMPALATH, Bal ; CHANG, Chung-Che ; BRESNAHAN, Barbara A ; HARIHARAN, Sundaram</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-j362t-fec4fef91bde5cedce5340b629c576ff0c68cefd7517f69a9c2ba263732f4ae53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Acute Disease</topic><topic>Adult</topic><topic>Antigens, CD20 - analysis</topic><topic>B-Lymphocytes - pathology</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Graft Rejection - pathology</topic><topic>Graft Survival</topic><topic>Humans</topic><topic>Immunohistochemistry - methods</topic><topic>Immunosuppressive Agents - adverse effects</topic><topic>Kidney - pathology</topic><topic>Kidney Transplantation</topic><topic>Lymphocyte Count</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mycophenolic Acid - adverse effects</topic><topic>Mycophenolic Acid - analogs &amp; derivatives</topic><topic>Papillomavirus Infections - chemically induced</topic><topic>Papillomavirus Infections - diagnosis</topic><topic>Papillomavirus Infections - immunology</topic><topic>Papillomavirus Infections - pathology</topic><topic>Polyomavirus</topic><topic>Staining and Labeling</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>T-Lymphocytes, Cytotoxic - pathology</topic><topic>Tacrolimus - adverse effects</topic><topic>Tumor Virus Infections - chemically induced</topic><topic>Tumor Virus Infections - diagnosis</topic><topic>Tumor Virus Infections - immunology</topic><topic>Tumor Virus Infections - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>AHUJA, Manohar</creatorcontrib><creatorcontrib>COHEN, Eric P</creatorcontrib><creatorcontrib>DAYER, Ann M</creatorcontrib><creatorcontrib>KAMPALATH, Bal</creatorcontrib><creatorcontrib>CHANG, Chung-Che</creatorcontrib><creatorcontrib>BRESNAHAN, Barbara A</creatorcontrib><creatorcontrib>HARIHARAN, Sundaram</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>AHUJA, Manohar</au><au>COHEN, Eric P</au><au>DAYER, Ann M</au><au>KAMPALATH, Bal</au><au>CHANG, Chung-Che</au><au>BRESNAHAN, Barbara A</au><au>HARIHARAN, Sundaram</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Polyoma virus infection after renal transplantation: Use of immunostaining as a guide to diagnosis</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2001-04-15</date><risdate>2001</risdate><volume>71</volume><issue>7</issue><spage>896</spage><epage>899</epage><pages>896-899</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><coden>TRPLAU</coden><abstract>Polyoma virus infection is characterized by lymphocytic interstitial infiltrate in the kidney, and it mimics acute rejection. The purpose of this study is to estimate renal allograft outcome with this infection and characterize the lymphocytic infiltrates in polyoma virus-infected renal allografts. Patients who had polyoma virus inclusions in renal allograft biopsies were identified. Other viral inclusions were excluded by immunohistochemistry. The lymphocytic infiltrates of six cases of polyoma virus infection were compared with six cases of definite acute rejection by immunostaining for T and B cells. There were 10 cases of polyoma virus infections in renal transplant recipients. Immunosuppressants consisted of mycophenolate mofetil with tacrolimus in eight cases and mycophenolate mofetil with cyclosporine in two. The median time of diagnosis of polyoma virus infection after transplantation was 9.5 months, and the time to graft failure after the diagnosis was 4 months. Reduced allograft survival was seen in patients who had polyoma virus infection. Immunostaining for T and B cells revealed marked increase in the B cells (CD20) in renal allografts with polyoma virus infection of 21% (range, 5-40%) compared with 6% (range, 0-10%) in those with acute rejection (P=0.039). Reduced cytotoxic T cells (TIA-1: median, 7%; range, 2-15%) were seen in polyoma virus-infected allografts compared with 24% (range, 15-30%) in those patients who had acute rejection (P=0.0159). Irreversible graft failure is more prevalent with polyoma virus infection. Enhanced immunosuppressants with mycophenolate mofetil with tacrolimus may play a role in the development of this infection. An increase in CD20 and a decrease in cytotoxic T cells in allografts is characteristic of polyoma virus infection.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>11349723</pmid><doi>10.1097/00007890-200104150-00013</doi><tpages>4</tpages></addata></record>
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subjects Acute Disease
Adult
Antigens, CD20 - analysis
B-Lymphocytes - pathology
Biological and medical sciences
Female
Graft Rejection - pathology
Graft Survival
Humans
Immunohistochemistry - methods
Immunosuppressive Agents - adverse effects
Kidney - pathology
Kidney Transplantation
Lymphocyte Count
Male
Medical sciences
Middle Aged
Mycophenolic Acid - adverse effects
Mycophenolic Acid - analogs & derivatives
Papillomavirus Infections - chemically induced
Papillomavirus Infections - diagnosis
Papillomavirus Infections - immunology
Papillomavirus Infections - pathology
Polyomavirus
Staining and Labeling
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
T-Lymphocytes, Cytotoxic - pathology
Tacrolimus - adverse effects
Tumor Virus Infections - chemically induced
Tumor Virus Infections - diagnosis
Tumor Virus Infections - immunology
Tumor Virus Infections - pathology
title Polyoma virus infection after renal transplantation: Use of immunostaining as a guide to diagnosis
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