BK病毒相关性肾病5例报告并文献复习

BK Virus Associated Nephropathy:a Report of Five Cases and Review of the Literature

目的:探讨BK病毒相关性肾病(BKVAN)的病理学特点和临床特征。方法:利用SV-40大T抗原免疫组化染色,对接受移植肾穿刺活检的117例病理学标本进行回顾研究,对诊断BKVAN的患者进行随访及病史复习。结果:5例患者诊断为BKVAN,占移植肾活检病例的4.3%。1例患者证实BKVAN后予以免疫抑制剂减量,肾功能明显好转。其余4例患者因当时未能及时诊断,1例已经发展为移植肾失功,其余3例患者治疗后效果不佳,血肌酐呈进行性上升。结论:BKVAN预后较差。利用SV-40大T抗原免疫组化染色可提高BKVAN的诊断率,对患者的治疗具有重要的指导意义。

Objective： To investigate pathological features and clinical characteristics of BK virus associated nephropathy （BKVAN）. Methods：We retrospectively analyzed 117 renal allograft biopsy specimens performed in Zhongshan Hospital from 2004 to 2007. BKVAN was diagnosed by light microscopic examination and a positive immunohistochemistry staining of anti- SV40 large T antibody in a biopsy specimen. Patients diagnosed with BKVAN were followed up and medical case histories were reviewed. Results： Among the 117 patients,5（4.3%） patients were diagnosed with BKVAN. One patient got improved by reduction in immunosuppressive therapy due to early diagnose of BKVAN. The remaining patients were not correctly diagnosed in time. Graft loss occurred in one patient and the other 3 showed progressive allograft dysfunction. Conclusion：Patients diagnosed with BKVAN indicated a poor prognosis. Early diagnose of BKVAN using immunohistochemistry method may provide directions for treatment interventions.