Late BK Nephropathy 15 years post kidney transplant following chemotherapy: A case report

BK Polyomavirus (BKPyV) is an important risk factor for premature graft loss following kidney transplant. Current practice guidelines recommend screening for BK virus DNA for 2 years after kidney transplant as the risk of BK Polyomavirus associated nephropathy (BKPyVAN) wanes over time. This case report presents a unique scenario of late onset BKPyVAN 15 years following kidney transplant precipitated by administration of chemotherapy to treat multiple myeloma. A woman in her 60 s with no prior history of BKPyV was diagnosed with multiple myeloma 14 years after kidney transplant. Her immunosuppression was tapered to tacrolimus and prednisone before undergoing chemotherapy treatment for her multiple myeloma. Although the chemotherapy was effective in achieving remission of her myeloma, she developed worsening renal dysfunction without proteinuria. Kidney biopsy revealed positive SV40 staining and subsequent BK DNA serum PCR was found to be 236,000 copies/mL suggestive of BKPyVAN. Although incredibly rare, late onset BKPyVAN should be considered as a cause of sustained elevation in serum creatinine, new onset proteinuria, or new onset hematuria in kidney transplant recipients who have experienced an augmentation in immunosuppression such as patients undergoing chemotherapy for underlying malignancies.

• Publication year

  2025

• Venue

  IDCases

• Publication date

  2025-08-08

• Fields of study

  Medicine

• Identifiers
  DOI 10.1016/j.idcr.2025.e02340PMID 40837613PMCID 12362014
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• The Second International Consensus Guidelines on the Management of BK Polyomavirus in Kidney Transplantation

  2024influential reference
• BK polyomavirus: latency, reactivation, diseases and tumorigenesis

  2023cited by this paper
• BK Virus Nephropathy in Kidney Transplantation: A State-of-the-Art Review

  2022cited by this paper
• Advances in BK Virus Complications in Organ Transplantation and Beyond

  2020cited by this paper
• BK Polyomavirus: Clinical Aspects, Immune Regulation, and Emerging Therapies

  2017influential reference
• Plasma cell neoplasia after kidney transplantation: French cohort series and review of the literature

  2017cited by this paper
• BK virus nephropathy in renal transplant recipients

  2016cited by this paper
• BK virus infection in transplant recipients: clinical manifestations, treatment options and the immune response.

  2012cited by this paper

• No citing papers are available for this paper.