case_images: PMC9537549_01
case_images: Pathological findings of renal allograft biopsy. Pathological findings before BAS treatment. Numerous graft-infiltrating cells can be seen in the renal interstitium (i2) (A, HE staining). Nuclear expression of SV40-T antigen (B, immunohistochemistry). The second renal allograft biopsy. Microvacuolar degeneration of renal tubular cells (C, HE staining). Persistent nuclear expression of SV40-T (D, immunohistochemistry).
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case_images: A graft biopsy showed BKV nephropathy (BKVN) classified with histological pattern stage B1 according to AST-IDCOP (American Society of Transplantation Infectious Diseases Community of Practice) and acute T cell-mediated rejection (TCMR) Banff grade IIA (I2, t2, ptc2, v1, c4d1, g0, SV40 positive) ( Figure 1 ). The biopsy features were consistent with BKVN injury (histological pattern stage A) without any evidence of acute rejection ( Figure 1 ).
case_images: Clinical course. Change of serum creatinine and immunosuppressive agents treatment. BAS, basiliximab; MP, methyl prednisolone; IVIG, intravenous immunoglobulin; CsA, cyclosporin; MMF, mycophenolate mofetil.
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case_images: Finally, he responded to the anti-rejection therapy, and Scr decreased to 182 micromol/L (2.06 mg/dL) thereafter ( Figure 2 ).
case_images: The CD4+ and CD8+ T cells levels at different time point.
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case_images: f3
case_images: T cells before and after BAS treatment were collected ( Figure 3 ). The CD4+ and CD8+ T cells levels are lower at the second biopsy compared with the first biopsy.