Friday, May 21, 2010


Which one is paired incorrectly?

Parvovirus B19- Collapsing FSGS
  2 (11%)
BK Nephropathy - Tubulo-interstitial Disease
  0 (0%)
Hantavirus- Tubulo-interstitial disease
  0 (0%)
Adenovirus - Collapsing FSGS
  7 (38%)
Measles- Acute interstitial Nephritis
  3 (16%)
Measles- Nephrotic Syndrome
  6 (33%)
Hantavirus - Interstitial Hemorrhage
  0 (0%

Tough question! Well, few are obvious but some are historical and one is incorrect.

Parvovirus B19 and collapsing FSGS or collapsing Glomeurlopathy(CG) has been reported now by many groups. Initially we thought that all cases of CG were idiopathic but parvovirus has been implicated in causes of CG in both non transplant and post transplant world.  
BK Virus traditionally causes an interstitial tubular disease. We know about that virus from our transplant experience and lately we are seeing cases of BK nephritis and BK cystitis in the Bone marrow transplant world as well.
Hanta virus, usually associated with systemic hemorrhage and even interstitial renal hemorrhage can also cause acute interstitial nephritis.
Measles, is a tough one. It has been associated with acute interstitial nephritis like most viruses are but there is an historical association with nephrotic syndrome as well. Check out some references below.
Adenovirus is not been reported to cause a CG so far. It has a more aggressive variant of acute interstitial nephritis, a necrotic variant usually.  Other viruses that are associated with CG are more of the Hepatitis, CMV and HIV/HTLV family of course.
HEP C is usually associated with MPGN , But IgA, post infectious, Membranous, Immunotactoid and Fibrillary GN has been reported as well
HEP B is usually Membranous GN but mesangioproliferative, MPGN, FSGS, and vasculitis has been reported.
CMV is usually AIN but also CG and TMA 

Mumps, and Dengue have been associated with acute interstitial nephritis

Some nice references for general viral nephropathies and the above mentioned discussion.

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