Abstract: TH-PO865
Urothelial Tumor in Transplant Patient with BK Nephropathy
Session Information
- Transplantation: Clinical - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- VankadariVenkata, Sai Srikar, Stanley Medical College, Chennai, Tamil Nadu, India
- Waid, Thomas H., University of Kentucky Medical Center, Lexington, Kentucky, United States
- Fattah, Hasan, University of Kentucky Medical Center, Lexington, Kentucky, United States
- Castellanos, Ana L., University of Kentucky Medical Center, Lexington, Kentucky, United States
- Lower, Fritz E., University of Kentucky Medical Center, Lexington, Kentucky, United States
- Rayapati, Protima, University of Kentucky Medical Center, Lexington, Kentucky, United States
- Paluri, Sravanthi, University of Kentucky Medical Center, Lexington, Kentucky, United States
Introduction
BK is a dsDNA virus in polyomaviridae family. BK does not cause disease in immunocompetent hosts.However BK can get activated in immunocompromised &cause BK nephropathy, ureteric stenosis in renal Tx, hemorrhagic cystitis in HSCT and rarely associated with urothelial carcinoma. We present a case of urothelial cancer in patient with persistent BK viremia,presenting with new onset microscopic hematuria.
Case Description
A 62 y/o WM with a history of LDKT in 2016, on Prograf, MMF, steroid. He developed BK viremia & nephritis 2 years postTx. Appropriate reduction in IS was implemented, along with wkly IVIG. His allograft function remained stable with CKD3b. BK viremia remained stable in the range of 40K -100K. He was found to have Microscopic Hematuria in 2022, cystoscopy revealed 2 Invasive Papillary bladder cancer which stained positive for BK by SV40 stain.
Discussion
BK Nephropathy is known cause of allograft loss, BK virus related malignancy is rarely reported &discussed. It is unclear if higher risk of Urothelial cancer in these immunocompromised hosts is directly related to IS & BK merely is an innocent bystander but new reports suggest role of BK in tumorigenesis. BK surveillance is recommended for upto 3 yrs post Tx. Our patient did not have any risk factors for bladder tumors other than persistent BK & IS meds. Persistent BK viremia and microscopic hematuria in transplant patients warrant further workup for urothelial cancers.