Native kidney BK virus nephropathy: A case report
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The present case has been reported in the Clinical Case Reports.

Sixty‐seven‐year‐old male presented for progressive renal failure and was admitted to oncology floor. His past medical history included mantle cell lymphoma in remission with history of allogeneic hematopoietic stem cell transplant (HSCT) 5 years ago. HSCT is complicated by hypogammaglobulinemia with recurrent upper respiratory viral infections 3 years ago, so he was given monthly infusions of intravenous immunoglobulin G (IVIG) over a period of 6 months.

Few months later, he developed chronic, cutaneous graft‐versus‐host disease (GVHD) with manifestation as diffuse scleroderma extending from the lower extremities to the neck. His scleroderma did not improve with outpatient treatment with neither rituximab nor ruxolitinib; however, it did remit and regress to only lower extremity involvement with ibrutinib 280 mg.

His clinical course had been complicated with frequent infections including pneumonia which responded to outpatient antibiotics, alongside of a steadily rising creatinine, the ibrutinib was discontinued in interval time.

Medications included mycophenolate mofetil 500 mg twice daily, sirolimus 1 mg every other day, acyclovir 600 mg daily, trimethoprim‐sulfamethoxazole 800‐160 mg twice weekly, and prednisone 10 mg daily.

Key Clinical Message
- BK virus nephropathy (BKN) is uncommonly reported in native kidneys; mostly reported in bone marrow transplant patients.

- This case report represents an interesting clinical scenario of biopsy‐proven BKN in native kidneys, in the presence of more than one million copies/mL of BK virus in serum.

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