Sinergia tra esperienza dell’operatore e analizzatori del sedimento urinario nella diagnosi di infezione da Poliomavirus BK

AUTORI

ABSTRACT

Laboratory professional and urinary sediment analyzer for the diagnosis of Polyomavirus BK infection.

Laboratory professional and urinary sediment analyzer for the diagnosis of Polyomavirus BK infection. Polyomavirus BK (BKV)-infected cells, (the so called decoy cells) were observed in two solid organ (kidney and lung) transplant recipients. In both patients, serum creatinine and BKV viremia were increased. Pharmacological immunodepression, during the 3-6 month period after transplantation, increases the risk of this viral infection and the related BKV nephropathy. Sedimax (Menarini), the automatic urinary sediment analyzer equipped with instrumental filters to select specific cellular patterns, utilized in our laboratory for urine examination, recognized some elements with enlarged ground glass–like nucleus and flagged them as “non-squamous epithelial cells”. By using a phase contrast microscopy, we re-analyzed these specific urinary samples and identified these elements as decoy cells. Serial urinary sediment analysis is strictly required both to search early infection signs and to switch the differential diagnosis from neoplastic to BKV-infected cells. These crucial findings, provided by the laboratory staff expertise, can accelerate clinical decisions improving thus the long term transplantation outcomes.

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