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The Korean Journal of Pathology 2010;44(6): 636-641.
doi: https://doi.org/10.4132/KoreanJPathol.2010.44.6.636
Comparison of Detecting Methods of BK Virus Infection in Patients with Renal Allograft Recipients.
Sung Hak Lee, Youn Jun Park, Chul Woo Yang, Yong Soo Kim, In Sung Moon, Chang Suk Kang, Yeong Jin Choi
1Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea. mdyjchoi@catholic.ac.kr
2Department of Laboratory Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
3Department of Nephrology, The Catholic University of Korea College of Medicine, Seoul, Korea.
4Department of General Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.
ABSTRACT
BACKGROUND: BK virus nephropathy (BKVN) is an emerging problem as a consequence of the use of potent immunosuppressive agents. Because optimal detection methods for the diagnosis of BKVN are required clinically, we compared the results of renal allograft biopsy, urine cytology, and urine and blood viral loads. METHODS: Four hundred sixty two case notes from 2004 to 2009 at Seoul St. Mary's Hospital were reviewed. During that period, 286 cases of urine cytology for decoy cells, 938 cases of urine BKV reverse transcription-polymerase chain reaction (RT-PCR), and 1,029 cases of blood BKV RT-PCR were performed. All diagnostic methods were performed in 85 cases. RESULTS: A histological diagnosis of BKVN was made in 2.4% of cases (11/462). Urine cytology for decoy cells was positive in 26.2% (75/286). BKV RT-PCR revealed viruria in positivity of 22.1% (207/938) and viremia in 5.2% (54/1,029). In cases of BKVN, the sensitivities of urine and blood BKV RT-PCR were all 100% and the specificities were 69% and 94.5%, respectively. In cases with positive urine decoy cells, the sensitivities of urine and blood BKV RT-PCR were 50% and 27.7%, with specificities of 77.7% and 100%, respectively. CONCLUSIONS: BKV screening by RT-PCR assays may be a clinically useful noninvasive test to identify renal recipients with concurrent BKVN.
Key Words: Kidney transplantation; BKV-associated nephropathy; Real-time PCR; Decoy cells; Urine cytology
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