A renal transplant @entity1 treated with @entity1140 and @entity618 ( @entity2098 ) developed progressive graft function deterioration 10 months after transplantation. Biopsy of the graft showed severe, focally accentuated @entity32 with focal @entity9538 and @entity4295 , and medium-severe interstitial @entity82 with focal tubular @entity194 . Glomerular and vascular structures were preserved. On careful examination, in some sections, tubular epithelial cells showed a definite increase with deformation of the nuclear shape, chromatin irregularities with @entity1897 and inclusion bodies. These cytopathic changes suggested polyoma @entity778 ("decoy cells"). Subsequent screening of the urinary sediment confirmed the presence of many "decoy cells". Immunohistochemical analysis of the biopsy showed many tubular cells were strongly positive for the SV 40 antigen, specific for BK polyoma virus. A diagnosis of @entity1986 due to BK polyoma virus was made, though the coexistence of cellular rejection could not be excluded. At variance with previous reports, our @entity1 had not had repeated episodes of rejection before biopsy or heavy immunosuppressive treatment, such as ALG, OKT3, after transplantation. This case shows that even in the absence of vigorous anti-rejection therapy an immunosuppressive regimen based on @entity1140 and @entity2098 may involve the risk of BK polyoma virus- associated @entity1986 .

BK polyomavirus XXXX in a renal transplant @entity1 with no previous acute rejection episodes.

@entity1 :: ('9606', 'Species') :: ['patient'] @entity32 :: ('MESH:D007249', 'Disease') :: ['interstitial inflammation'] @entity9538 :: ('MESH:D007673', 'Disease') :: ['tubulitis'] @entity82 :: ('MESH:D005355', 'Disease') :: ['fibrosis'] @entity778 :: ('MESH:D015658', 'Disease') :: ['virus infection'] @entity4295 :: ('MESH:D007683', 'Disease') :: ['tubular necrosis'] @entity1986 :: ('MESH:D009395', 'Disease') :: ['interstitial nephritis'] @entity1897 :: ('MESH:D010523', 'Disease') :: ['peripheral dislocation'] @entity2098 :: ('CHEBI:8764', 'Chemical') :: ['MMF'] @entity618 :: ('MESH:C063008', 'Chemical') :: ['mycophenolate-mofetil'] @entity194 :: ('MESH:D001284', 'Disease') :: ['atrophy'] @entity1140 :: ('MESH:D016559', 'Chemical') :: ['tacrolimus']
@entity1986 :: (MESH:D009395,Disease) :: ['interstitial nephritis']
