JC virus in transplant patients may cause neurologic symptoms.
Dr. Manna warned that JC virus infection could be associated with neurologic findings in addition to allograft dysfunction in kidney transplant patients. "One has to look if there are any neurologic problems, along with [rising] creatinine levels that might be evidence of JC virus infection," said Dr. Manna of ViraCor Laboratories, Lee's Summit, Mo.
JC virus is a recognized pathogen for progressive multifocal leukoencephalopathy, an incurable disease associated with demyelination of the CNS.
Based on 218 urine specimens and 319 blood specimens from 242 patients, the study showed that up to 26% of patients with suspected BK virus infection could have a JC virus infection or coinfection. Nearly all the patients (97%) tested positive for BK or JC virus. About 22% had both viruses, and 4% had JC virus alone.
Two patients with no detectable BK virus had rising creatinine levels and neurologic symptoms that suggest JC virus infection could have a different course from BK virus infection, Dr. Manna said at the congress, cosponsored by the American Society of Transplantation and the American Society of Transplant Surgeons.
One was a 43-year-old woman who presented with depression and excess sleepiness 2 years post transplant. A biopsy revealed few glomeruli with mesangial expansion, diffuse tubular atrophy with hyperchromasia and enlargement The other patient was a 21-year-old woman who presented with short-term memory dysfunction, numbness in her upper extremities, tingling, irritability, and depression 4 years post transplant. A biopsy showed sclerotic glomeruli and patchy tubular atrophy. Neither patient had viral inclusions.
BY JANE SALODOF MACNEIL
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|Publication:||Internal Medicine News|
|Article Type:||Brief Article|
|Date:||Jul 15, 2004|
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