AUTHOR=Abu Jawdeh Bassam G. , Smith Maxwell L. , Hudson Madeline R. , Mour Girish K. , Budhiraja Pooja , Rosenthal Julie L. 

TITLE=Case report: JC polyomavirus nephropathy in simultaneous heart–kidney transplantation: the role of viral-specific in situ hybridization staining

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1282827

DOI=10.3389/fmed.2023.1282827

ISSN=2296-858X

ABSTRACT=Introduction: JC polyomavirus (JCPyV) is a ubiquitous virus that can be latent in the brain and the kidney. It is the etiologic agent responsible for progressive multifocal leukoencephalopathy, a fatal, demyelinating disease of the central nervous system, and rarely causes polyomavirus nephropathy in immunocompromised kidney transplant recipients. 
Case description: We present the first case of JCPyV nephropathy in a simultaneous heart-kidney transplant patient, where viral-specific in situ hybridization staining of the kidney tissue was utilized to confirm the diagnosis. The patient was diagnosed six years after simultaneous heart-kidney transplantation, and was treated with immunosuppression reduction and intravenous immunoglobulin.
Discussion: JCPyV nephropathy should be considered in the differential diagnosis of kidney allograft injury, particularly, with suggestive light microscopy histologic features in absence of BK polyomavirus viremia and/or viruria. In addition to obtaining JCPyV PCR in the blood, in situ hybridization staining may have a utility in confirming the diagnosis.  To date, we lack effective JCPyV-specific therapies, and prompt initiation of immunosuppression reduction remains the mainstay of treatment.