1. Collapsing Glomerulopathy Leading To Rapidly Progressive Allograft Failure From Cytomegalovirus and SARS-CoV-2 Infection With Concomitant BK Virus Nephropathy.
- Author
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Sharma R, Gonzalez M, Chaudhary V, Villanueva D, Newman C, Danforth J, and Amin MS
- Subjects
- Humans, Female, Aged, Disease Progression, Treatment Outcome, Immunosuppressive Agents adverse effects, Immunosuppressive Agents therapeutic use, Coinfection, COVID-19 complications, COVID-19 immunology, COVID-19 diagnosis, Kidney Transplantation adverse effects, Polyomavirus Infections immunology, Polyomavirus Infections virology, Polyomavirus Infections diagnosis, Cytomegalovirus Infections immunology, Cytomegalovirus Infections diagnosis, Cytomegalovirus Infections virology, Cytomegalovirus Infections drug therapy, Graft Rejection immunology, Graft Rejection virology, BK Virus pathogenicity, BK Virus immunology, Tumor Virus Infections immunology, Tumor Virus Infections virology, Tumor Virus Infections diagnosis
- Abstract
We present a challenging clinical case of a 68-year-old female kidney transplant recipient who had a complicated posttransplant course marked by borderline T-cell-mediated rejection and BK virus nephropathy. The treatment for borderline rejection with steroids resulted in overimmunosuppression, and the patient acquired cytomegalovirus infection manifesting as colitis and SARS-CoV-2 infection. This progressed rapidly to collapsing glomerulopathy and allograft failure. This study also highlights the challenges in surveillance with donor-derived cell-free DNA in the setting of allograft injury by multiple viral infections.
- Published
- 2024
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