Figure 1051

Viruses that cause interstitial nephritis in renal transplant recipients. Consider this condition when nonspecific inflammation is seen on biopsy or unexplained rejection occurs. Viruses may cause renal disease by direct infection of the glomerular and/or tubular cells or by the immune response directed against virally infected cells. Most commonly nonspecific interstitial inflammation is seen but severe tubular injury by mononuclear cells, peritubular inflammation, and interstitial fibrosis may also be seen. The presentation of virally mediated interstitial nephritis may be acute or subacute. In addition to routine light microscopy, occasionally evaluation by immunofluorescence, electron microscopy, or special stains for light microscopy are necessary to make the diagnosis.

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