Journal of Pathology and Translational Medicine

Original Articles

Urinary Decoy Cell Grading and Its Clinical Implications: Myoung Ju Koh, Beom Jin Lim, Songmi Noh, Yon Hee Kim, Hyeon Joo Jeong; Korean J Pathol. 2012;46(3):233-236. Published online June 22, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.3.233

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Background

Examination of urine for decoy cells (DCs) is a useful screening test for polyomavirus (PV) activation. We explored the significance of the amount of DCs in persistent shedding, PV nephropathy and acute rejection.

Methods

A case-controlled study was performed in 88 renal allograft patients who had DCs detected at least once in four or more urine samples.

Results

Fifty one patients were classified into the high-grade shedding group (HG) and 37 patients into the low-grade shedding group (LG) according to DC shedding (≥10 or <10 DCs/10 high power field [HPF]). DC shedding of more than three consecutive months was significantly more prevalent in the HG as compared with their LG counterparts (p<0.0001). Urinary DCs were present for more than one year in 29.4% of the HG and 8.1% of the LG. Real-time polymerase chain reaction for PV was higher in both urine (51.4% vs. 11.1%) and plasma (9.1% vs. 0%) of the HG than the LG. The prevalence of PV nephropathy was higher in the HG than the LG (p=0.019). However, there was no significant difference in the prevalence of acute rejection.

Conclusions

Shedding of ≥10 DCs/10 HPF is associated with sustained shedding, polymerase chain reaction positivity and PV nephropathy, but not a predictor of acute rejection.

Citations

Citations to this article as recorded by

Polyomavirus nephropathy: diagnosis, histologic features, and differentiation from acute rejection
Cynthia C. Nast
Clinical Transplantation and Research.2024; 38(2): 71. CrossRef
Challenges and opportunities in research on BK virus infection after renal transplantation
Yukun Tang, Zipei Wang, Dunfeng Du
International Immunopharmacology.2024; 141: 112793. CrossRef
BK Virus-Associated Nephropathy after Renal Transplantation
Yasuhito Funahashi
Pathogens.2021; 10(2): 150. CrossRef
Diagnostic utility of urine cytology in detection of decoy cells in renal transplant patients: Report of five cases and review of literature
Santosh Tummidi, Kanchan Kothari, Mona Agnihotri, Leena Naik, Amey Rojekar
Diagnostic Cytopathology.2020; 48(3): 222. CrossRef
Association of Pretransplant BK Polyomavirus Antibody Status with BK Polyomavirus Infection After Kidney Transplantation: A Prospective Cohort Pilot Study of 47 Transplant Recipients
Yu Hisadome, Hiroshi Noguchi, Yuki Nakafusa, Kukiko Sakihama, Takanori Mei, Keizo Kaku, Yasuhiro Okabe, Kosuke Masutani, Yuki Ohara, Kazuyuki Ikeda, Yoshinao Oda, Masafumi Nakamura
Transplantation Proceedings.2020; 52(6): 1762. CrossRef
Association Between the Polyomaviruses Titers and Decoy Cell Positivity Rates After Renal Transplantation
Y. Funahashi, M. Kato, T. Fujita, S. Ishida, A. Mori, M. Gotoh
Transplantation Proceedings.2016; 48(3): 921. CrossRef

Comparison of Detecting Methods of BK Virus Infection in Patients with Renal Allograft Recipients.: Sung Hak Lee, Youn Jun Park, Chul Woo Yang, Yong Soo Kim, In Sung Moon, Chang Suk Kang, Yeong Jin Choi; Korean J Pathol. 2010;44(6):636-641.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.636

3,494 View
24 Download
2 Crossref

Abstract PDF

BACKGROUND
BK virus nephropathy (BKVN) is an emerging problem as a consequence of the use of potent immunosuppressive agents. Because optimal detection methods for the diagnosis of BKVN are required clinically, we compared the results of renal allograft biopsy, urine cytology, and urine and blood viral loads.
METHODS
Four hundred sixty two case notes from 2004 to 2009 at Seoul St. Mary's Hospital were reviewed. During that period, 286 cases of urine cytology for decoy cells, 938 cases of urine BKV reverse transcription-polymerase chain reaction (RT-PCR), and 1,029 cases of blood BKV RT-PCR were performed. All diagnostic methods were performed in 85 cases.
RESULTS
A histological diagnosis of BKVN was made in 2.4% of cases (11/462). Urine cytology for decoy cells was positive in 26.2% (75/286). BKV RT-PCR revealed viruria in positivity of 22.1% (207/938) and viremia in 5.2% (54/1,029). In cases of BKVN, the sensitivities of urine and blood BKV RT-PCR were all 100% and the specificities were 69% and 94.5%, respectively. In cases with positive urine decoy cells, the sensitivities of urine and blood BKV RT-PCR were 50% and 27.7%, with specificities of 77.7% and 100%, respectively.
CONCLUSIONS
BKV screening by RT-PCR assays may be a clinically useful noninvasive test to identify renal recipients with concurrent BKVN.

Citations

Citations to this article as recorded by

Prevalence of BK Virus among Iranian Renal Transplant Recipients: A Systematic Review and Meta-Analysis
Mohsen Ebrahimi, Alireza Mohebbi, Mohammad Mostakhdem Hashemi, Mobina Ashrafi Shahmirzadi
Journal of Clinical and Basic Research.2020; 4(4): 50. CrossRef
Asymptomatic hematuria associated with urinary polyomavirus infection in immunocompetent patients
Sung Hak Lee, Sung Hoo Hong, Ji Youl Lee, Tae Kon Hwang, Kyoung Suk Kim, Hyoungnam Lee, Yeong Jin Choi
Journal of Medical Virology.2014; 86(2): 347. CrossRef

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