{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T14:14:41Z","timestamp":1758636881509,"version":"3.41.2"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,6,22]],"date-time":"2018-06-22T00:00:00Z","timestamp":1529625600000},"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":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Evolving <jats:styled-content style=\"fixed-case\">BK<\/jats:styled-content> polyomavirus\u2013associated nephropathy (<jats:styled-content style=\"fixed-case\">BKP<\/jats:styled-content>y<jats:styled-content style=\"fixed-case\">VAN<\/jats:styled-content>) is characterized by tubulointerstitial inflammation that closely resembles acute T\u2010cell\u2013mediated allograft rejection if tubulitis is significant. The cellular composition of the inflammation varies during the course of <jats:styled-content style=\"fixed-case\">BKP<\/jats:styled-content>y<jats:styled-content style=\"fixed-case\">VAN<\/jats:styled-content>, and clusters of plasma cells may herald resolution of the infection. Less commonly, <jats:styled-content style=\"fixed-case\">BKP<\/jats:styled-content>y<jats:styled-content style=\"fixed-case\">VAN<\/jats:styled-content> can present with a predominance of histiocytes and granuloma formation. Granulomatous interstitial nephritis is uncommon in biopsies of either native or transplant kidneys. In both settings, this distinctive type of inflammatory response requires a systematic approach with careful clinicopathological assessment to determine its etiology. We present three patients with granulomatous <jats:styled-content style=\"fixed-case\">BKP<\/jats:styled-content>y<jats:styled-content style=\"fixed-case\">VAN<\/jats:styled-content> in the first year post\u2010transplantation. These allograft biopsies at 4, 6, and 12\u00a0months post\u2010transplant exemplify spontaneously resolving <jats:styled-content style=\"fixed-case\">BKP<\/jats:styled-content>y<jats:styled-content style=\"fixed-case\">VAN<\/jats:styled-content>, resolving infection after immunosuppression reduction, and early <jats:styled-content style=\"fixed-case\">BKP<\/jats:styled-content>y<jats:styled-content style=\"fixed-case\">VAN<\/jats:styled-content>, respectively. In immunosuppressed patients, <jats:styled-content style=\"fixed-case\">BKP<\/jats:styled-content>y<jats:styled-content style=\"fixed-case\">VAN<\/jats:styled-content> should be added to the relatively broad differential diagnosis of granulomatous tubulointerstitial nephritis.<\/jats:p>","DOI":"10.1111\/tid.12939","type":"journal-article","created":{"date-parts":[[2018,6,4]],"date-time":"2018-06-04T14:41:10Z","timestamp":1528123270000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Granulomatous inflammation in <scp>BK<\/scp> polyomavirus\u2013associated nephropathy"],"prefix":"10.1111","volume":"20","author":[{"given":"Yang","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Pathology University of Maryland School of Medicine  Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiba","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Maryland School of Medicine  Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdolreza","family":"Haririan","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Maryland School of Medicine  Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Ugarte","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Maryland School of Medicine  Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C.","family":"Papadimitriou","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Maryland School of Medicine  Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3104-5661","authenticated-orcid":false,"given":"Cinthia B.","family":"Drachenberg","sequence":"additional","affiliation":[{"name":"Department of Pathology 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