POLYOMAVIRUS-INDUCED INTERSTITIAL NEPHRITIS IN 2 RENAL-TRANSPLANT RECIPIENTS - CASE-REPORTS AND REVIEW OF THE LITERATURE

We present two case reports of renal polyomavirus infection leading to renal allograft dysfunction, review the literature of this entity, an d discuss the role of specific immunosupressives. Histologically, the virus caused an interstitial infiltrate composed of plasma cells and l ymphocytes, interstitial fibrosis, and tubular atrophy. Viral inclusio ns were seen within tubular cells on light microscopy. Electron micros copy showed viral particles of 40 to 50 nm in a characteristic paracry stalline array. Both patients had been on FK-506-based immunosuppressi on. In both patients, the virus appeared to clear histologically and r enal function stabilized when the patients were converted to cyclospor ine-based immunosuppression. Contrary to prior reports, our patients h ave not lost their grafts and continue to have stable, albeit reduced, graft function at 2.5 years and 4.5 years following the initial diagn osis of renal polyomavirus infection. (C) 1997 by the National Kidney Foundation, Inc.