{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:04:19Z","timestamp":1744157059665},"reference-count":14,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2014,5,20]],"date-time":"2014-05-20T00:00:00Z","timestamp":1400544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We report the successful management of <jats:styled-content style=\"fixed-case\">BK<\/jats:styled-content> virus nephropathy (<jats:styled-content style=\"fixed-case\">BKVN<\/jats:styled-content>) using therapeutic drug monitoring (<jats:styled-content style=\"fixed-case\">TDM<\/jats:styled-content>) of mycophenolic acid (<jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content>). A 40\u2010year\u2010old woman was admitted for a protocol biopsy 3 months following primary kidney transplantation. Histological features were distributed in mainly two sections: the corticomedullary junction and cortical area. In the former, massive interstitial mononuclear cell infiltration and mild to moderate tubulitis with nuclear inclusion bodies were found. <jats:styled-content style=\"fixed-case\">SV40<\/jats:styled-content> staining was positive in the injured tubules. These findings were compatible with <jats:styled-content style=\"fixed-case\">BKVN<\/jats:styled-content>. In the latter, focal interstitial inflammation and severe tubulitis without cytopathic changes were identified outside of <jats:styled-content style=\"fixed-case\">SV40<\/jats:styled-content>\u2010positive areas. Based on the histological findings, we diagnosed <jats:styled-content style=\"fixed-case\">BKVN<\/jats:styled-content> and we also suspected of the complication with acute <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>\u2010cell\u2010mediated rejection. We started steroid pulse therapy and reduced the dosage of immunosuppressive therapy under careful monitoring, using not only a trough level of tacrolimus but also a 12\u2010h area under the curve (<jats:styled-content style=\"fixed-case\">AUC<jats:sub>0\u201312<\/jats:sub><\/jats:styled-content>) of <jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content>. After the treatment, the patient maintained kidney function. This case report demonstrates the usefulness of <jats:styled-content style=\"fixed-case\">MPA AUC<jats:sub>0\u201312<\/jats:sub><\/jats:styled-content> for more accurate adjustment of immunosuppressive therapy and the difficulty of pathological differentiation of <jats:styled-content style=\"fixed-case\">BKVN<\/jats:styled-content> and acute cellular rejection.<\/jats:p>","DOI":"10.1111\/nep.12249","type":"journal-article","created":{"date-parts":[[2014,5,20]],"date-time":"2014-05-20T07:26:00Z","timestamp":1400570760000},"page":"37-41","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Successful treatment of <scp>BK<\/scp> virus nephropathy using therapeutic drug monitoring of mycophenolic acid"],"prefix":"10.1111","volume":"19","author":[{"given":"Akimitsu","family":"Kobayashi","sequence":"first","affiliation":[{"name":"Division of Kidney and Hypertension Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Izumi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Division of Kidney and Hypertension Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuyuki","family":"Nakada","sequence":"additional","affiliation":[{"name":"Division of Kidney and Hypertension Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Kidoguchi","sequence":"additional","affiliation":[{"name":"Division of Kidney and Hypertension Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanae","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Division of Kidney and Hypertension Department of 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