BK Polyoma Virus Nephropathy in an Immunocompromised Host

Background: Post-transplant Lymphoproliferative Disorders (PTLD) are a well known late complication after solid organ transplantation, including renal transplant. Among others, graft failure due to reactivation of BK polyomavirus in the grafted kidney is also a well-recognized complication but tends to present early in the first several months after transplant. Case: Here we present the case of PTLD Burkitt's Lymphoma (BL-PTLD) in a renal transplant patient who was successfully treated with multiagent chemo-immunotherapy but later developed BK polyomavirus nephropathy (BKVN) with graft failure only after completion of her systemic therapy for lymphoma and 7 years after the transplant. Relevant literature is reviewed. Conclusion: In this case, reactivation and progression of BKVN were most likely associated with immunosuppression from chemo-immunotherapy for her BL–PTLD, unlike early graft failures associated with BKVN.