BK virus nephropathy in an immunodeficient patient with chronic lymphocytic leukemia

Background: BK virus, genus polyomavirus, is known as an important cause of nephropathy (BKVN) in renal transplant patients. Cases of BKVN in native kidneys are rare. Objectives: To report a case of BKVN in a patient with chronic lymphocytic leukemia (CLL) and to examine viral and immune parameters. Study design: Quantitative BK virus DNA in plasma and relevant immune parameters were recorded in one CLL patient with BKVN and ten consecutive CLL patients without BKVN. Results: BKVN in the native kidneys of a CLL patient was histologically confirmed. The presence of BKVN correlated with immunologic parameters as well as factors known to cause renal tissue injury. BK viral load levels in the patient steadily increased and exceeded those of the control CLL patients. Conclusions: The results document a pathogenic role for BK virus in native kidneys of immuno-compromised CLL patients and indicate a role for quantitative BK virus DNA detection for early management of BKVN in native kidneys.

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