BK virus - Revision history

Aidan at 17:15, 19 September 2024

2024-09-19T17:15:25Z

← Older revision		Revision as of 17:15, 19 September 2024
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	==Background==		==Background==
	===Microbiology===		===Microbiology===
	* Double-stranded DNA virus in the ''Polyomaviridae'' family		* Double-stranded DNA virus in the [[Family::Polyomaviridae]] family

	===Epidemiology===		===Epidemiology===
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	=== Nephropathy ===		=== Nephropathy ===
	* Nephropathy: screening with urine or blood PCR followed by biopsy if concurrent renal dysfunction to confirm the diagnosis		* Nephropathy: screening with urine or blood PCR followed by biopsy if concurrent renal dysfunction to confirm the diagnosis
			* BKV Transplantation Associated Virus Infections Working Group developed a consensus definition[[CiteRef::imlay2022co]]
	* BKV Transplantation Associated Virus Infections Working Group developed a consensus definition<ref>Hannah Imlay, Paul Baum, Daniel C Brennan, Kimberly E Hanson, Michael R Hodges, Aimee C Hodowanec, Takashi E Komatsu, Per Ljungman, Veronica Miller, Yoichiro Natori, Volker Nickeleit, Jules O’Rear, Andreas Pikis, Parmjeet S Randhawa, Deirdre Sawinski, Harsharan K Singh, Gabriel Westman, Ajit P Limaye, BK Disease Definitions Working Group of the Transplantation Associated Virus Infection Forum With the Forum for Collaborative Research, Consensus Definitions of BK Polyomavirus Nephropathy in Renal Transplant Recipients for Clinical Trials, ''Clinical Infectious Diseases'', Volume 75, Issue 7, 1 October 2022, Pages 1210–1216, <nowiki>https://doi.org/10.1093/cid/ciac071</nowiki></ref>
	** Proven: demonstration of active BKV within renal tissue by IHC for SV40 or ISH		** Proven: demonstration of active BKV within renal tissue by IHC for SV40 or ISH
	** Probable: requires all of the following:		** Probable: requires all of the following:

Aidan: /* Diagnosis */ added consensus definition

2022-10-07T01:51:42Z

Diagnosis: added consensus definition

@@ Line 29: / Line 29: @@
 ==Diagnosis==
 * Nephropathy: screening with urine or blood PCR followed by biopsy if concurrent renal dysfunction to confirm the diagnosis
 * Hemorrhagic cystitis: urine PCR is relatively non-specific, although a high viral load may be supportive
 * Urine cytology may show decoy cells, though they are also seen in CMV and adenovirus

Aidan at 17:12, 15 February 2022

2022-02-15T17:12:37Z

← Older revision		Revision as of 17:12, 15 February 2022
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	** Occasional hematuria and fever		** Occasional hematuria and fever

	===Ureteral ~~stenosis~~===		===[[Ureteral Stenosis]]===
	* Causes urinary obstruction and AKI in the donor kidney, usually without pain since it is not innervated		* Causes urinary obstruction and AKI in the donor kidney, usually without pain since it is not innervated

	===Hemorrhagic cystitis===		===[[Hemorrhagic cystitis\|Hemorrhagic Cystitis]]===
	* Complicates 10 to 25% of [[hematopoietic stem cell transplantation]]s, most commonly in the context of [[GVHD]]		* Complicates 10 to 25% of [[hematopoietic stem cell transplantation]]s, most commonly in the context of [[GVHD]]
	* Symptoms include hematuria, dysuria, urinary urgency and frequency, and suprapubic pain		* Symptoms include [[hematuria]], dysuria, urinary urgency and frequency, and suprapubic pain
	* Clotting hematuria can cause urinary obstruction and renal failure		* Clotting hematuria can cause urinary obstruction and renal failure

	===Other ~~syndromes~~===		===Other Syndromes===
	* Very rarely causes encephalitis and pneumonitis		* Very rarely causes [[encephalitis]] and [[pneumonitis]]

	==Diagnosis==		==Diagnosis==

Aidan: categories

2020-08-07T14:34:14Z

Aidan: Text replacement - "Clinical Presentation" to "Clinical Manifestations"

2020-07-21T01:21:55Z

Text replacement - "Clinical Presentation" to "Clinical Manifestations"

← Older revision		Revision as of 01:21, 21 July 2020
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	* Hemorrhagic cystitis is seen in 10 to 25% of [[hematopoietic stem cell transplantation]] recipients		* Hemorrhagic cystitis is seen in 10 to 25% of [[hematopoietic stem cell transplantation]] recipients

	==Clinical ~~Presentation~~==		==Clinical Manifestations==
	===Nephropathy===		===Nephropathy===
	* Typically a cause of nephropathy in renal transplant patients		* Typically a cause of nephropathy in renal transplant patients

Aidan: /* Diagnosis */

2020-05-23T23:57:19Z

Diagnosis

← Older revision		Revision as of 23:57, 23 May 2020
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	==Diagnosis==		==Diagnosis==
			* Nephropathy: screening with urine or blood PCR followed by biopsy if concurrent renal dysfunction to confirm the diagnosis
	* Positive urine PCR with renal failure in a renal transplant patient is diagnostic for nephropathy, especially with sustained viruria
	** ~~In hemorrhagic~~ cystitis, urine PCR is ~~less~~ specific, although a high viral load may be supportive		* Hemorrhagic cystitis: urine PCR is relatively non-specific, although a high viral load may be supportive
	* Urine cytology may show decoy cells, though they are also seen in CMV and adenovirus		* Urine cytology may show decoy cells, though they are also seen in CMV and adenovirus

Aidan: Created page with "==Background== ===Microbiology=== * Double-stranded DNA virus in the ''Polyomaviridae'' family ===Epidemiology=== * Very high seroprevalence with asymptomatic infection ocurr..."

2020-05-23T19:17:14Z

Created page with "==Background== ===Microbiology=== * Double-stranded DNA virus in the ''Polyomaviridae'' family ===Epidemiology=== * Very high seroprevalence with asymptomatic infection ocurr..."

New page

==Background==
===Microbiology===
* Double-stranded DNA virus in the ''Polyomaviridae'' family

===Epidemiology===
* Very high seroprevalence with asymptomatic infection ocurring in childhood
* Disease is seen in immunosuppressed patients, especially renal transplant recipients
* BKV nephropathy is seen in 1 to 10% of renal transplant recipients
* BKV ureteric stenosis is seen in about 3% of renal transplant recipients
* Hemorrhagic cystitis is seen in 10 to 25% of [[hematopoietic stem cell transplantation]] recipients

==Clinical Presentation==
===Nephropathy===
* Typically a cause of nephropathy in renal transplant patients
* Onset is 10 to 13 months post-transplant, with a wide range of 6 days to 5 years
* Presents with slowly increasing creatinine levels
** Occasional hematuria and fever

===Ureteral stenosis===
* Causes urinary obstruction and AKI in the donor kidney, usually without pain since it is not innervated

===Hemorrhagic cystitis===
* Complicates 10 to 25% of [[hematopoietic stem cell transplantation]]s, most commonly in the context of [[GVHD]]
* Symptoms include hematuria, dysuria, urinary urgency and frequency, and suprapubic pain
* Clotting hematuria can cause urinary obstruction and renal failure

===Other syndromes===
* Very rarely causes encephalitis and pneumonitis

==Diagnosis==
* Positive urine PCR with renal failure in a renal transplant patient is diagnostic for nephropathy, especially with sustained viruria
** In hemorrhagic cystitis, urine PCR is less specific, although a high viral load may be supportive
* Urine cytology may show decoy cells, though they are also seen in CMV and adenovirus

==Management==
* There is no directed therapy
* Nephropathy is typically managed by decreasing immunosuppression, monitoring viremia for response
* Ureteral stenosis is similarly managed, but may require surgical intervention
* Hemorrhagic cystitis is managed supportively, with continuous bladder irrigation, analgesia, hydration, and transfusion of platelets or erythrocytes as needed
** Target for platelets is >50k

==Prevention==
* In renal transplant patients, monitor for viremia monthly after transplant, decreasing immunosuppression if positive

[[Category:DNA viruses]]

← Older revision		Revision as of 14:34, 7 August 2020
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	* In renal transplant patients, monitor for viremia monthly after transplant, decreasing immunosuppression if positive		* In renal transplant patients, monitor for viremia monthly after transplant, decreasing immunosuppression if positive

	[[Category:~~DNA viruses~~]]		[[Category:Polyomaviridae]]