{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T22:11:09Z","timestamp":1766182269549,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>As there is no specific antiviral treatment currently available for BK polyomavirus associated nephropathy (BKVAN), its management relies on immunosuppression reduction in kidney transplant patients. Data on efficacy of steroid pulses in this indication are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective monocenter study on 64 patients diagnosed with biopsy\u2010proven BKVAN. Patients within the \u201cpulse group\u201d (<jats:italic>n<\/jats:italic> = 37) received IV methylprednisolone 10\u00a0mg\/kg 3 days consecutively. In the \u201clow dose\u201d steroid group (<jats:italic>n<\/jats:italic> = 27), patients were continued oral prednisone 5\u00a0mg daily.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean follow up was 78 months in the steroid pulse group and 56 months in the low dose group (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.15). Mean eGFR values at diagnosis were comparable, as well as other demographic characteristics. Mean BK plasma viral load was higher in \u201cpulse\u201d than in \u201clow dose\u201d steroid group. Pulse group had higher inflammation and tubulitis (<jats:italic>p<\/jats:italic> &lt;\u00a00.05). Graft loss reached 57% in the \u201cpulse\u201d group versus 41% in the \u201clow dose\u201d group, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.20. Rejection events were similar. No major adverse event was statistically associated with steroid pulse, including infections, cancer, and de novo diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>No significant differences were found in the evolution of both groups of patients, despite patients receiving \u201cpulse\u201d steroids were identified as the most severe sharing higher BK viral load and more frequent active lesions on histology.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14260-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14260","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T16:35:39Z","timestamp":1711643739000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of steroid pulses in severe BK virus allograft nephropathy with extensive interstitial inflammation"],"prefix":"10.1111","volume":"26","author":[{"given":"Julien","family":"Carrillo","sequence":"first","affiliation":[{"name":"Department of Nephrology and Organ Transplantation Referral Centre for Rare Kidney Diseases, French Intensive Care Renal Network University Hospital of Toulouse  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3115-868X","authenticated-orcid":false,"given":"Arnaud","family":"Del Bello","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Organ Transplantation Referral Centre for Rare Kidney Diseases, French Intensive Care Renal Network University Hospital of Toulouse  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Sallusto","sequence":"additional","affiliation":[{"name":"Department of Urology and Kidney Transplantation CHU Rangueil  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Audrey","family":"Delas","sequence":"additional","affiliation":[{"name":"Department of Pathology University Hospital of Toulouse University Cancer Institute of Toulouse  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magali","family":"Colombat","sequence":"additional","affiliation":[{"name":"Department of Pathology University Hospital of Toulouse University Cancer Institute of Toulouse  Toulouse France"},{"name":"Universit\u00e9 Toulouse III  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean Michel","family":"Mansuy","sequence":"additional","affiliation":[{"name":"Laboratory of Virology Institut f\u00e9d\u00e9ratif de Biologie University Hospital of Toulouse  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacques","family":"Izopet","sequence":"additional","affiliation":[{"name":"Laboratory of Virology Institut f\u00e9d\u00e9ratif de Biologie University Hospital of Toulouse  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1930-8964","authenticated-orcid":false,"given":"Nassim","family":"Kamar","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Organ Transplantation Referral Centre for Rare Kidney Diseases, French Intensive Care Renal Network University Hospital of Toulouse  Toulouse France"},{"name":"Universit\u00e9 Toulouse III  Toulouse France"},{"name":"INSERM UMR1291\u2010CNRS UMR5051  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4229-8584","authenticated-orcid":false,"given":"Julie","family":"Belliere","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Organ Transplantation Referral Centre for Rare Kidney Diseases, French Intensive Care Renal Network University Hospital of Toulouse  Toulouse France"},{"name":"Universit\u00e9 Toulouse III  Toulouse France"},{"name":"INSERM U1297, Institute of Metabolic and Cardiovascular Diseases  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020439"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0142460"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31825a505d"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14314"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.08420813"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2013.08.033"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(03)00770-9"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/23744235.2019.1595130"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13528"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.12991117"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12110"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12604"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31817c6447"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181837802"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31826690c6"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15898"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12530"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.23876\/j.krcp.2018.37.2.167"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523\u20101755.2005.00602.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14530"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2012.03993.x"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002887"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1128\/jvi.68.4.2398-2408.1994"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.03625\u201014"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep32273"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20072097"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.14260","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T11:05:10Z","timestamp":1712833510000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.14260"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,28]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/tid.14260"],"URL":"https:\/\/doi.org\/10.1111\/tid.14260","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"type":"print","value":"1398-2273"},{"type":"electronic","value":"1399-3062"}],"subject":[],"published":{"date-parts":[[2024,3,28]]},"assertion":[{"value":"2023-08-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14260"}}