# BK and JC polyomavirus co-infection resulting in polyomavirus nephropathy and progressive multifocal leukoencephalopathy at the same time, a case report

**Authors:** Sébastien Briol, Laura Labriola, Arnaud Devresse, Benoit Kabamba, Valeria Onofrj, Leïla Belkhir

PMC · DOI: 10.1016/j.bjid.2025.104607 · 2026-01-20

## TL;DR

This case report describes the first known instance of two polyomavirus infections occurring simultaneously in a non-transplanted patient, affecting the brain and kidneys.

## Contribution

The first reported case of concurrent PML and PVN due to co-infection with JCV and BKV in a non-transplanted individual.

## Key findings

- Co-infection with JCV and BKV led to PML and PVN simultaneously in a non-transplanted patient.
- The case suggests JCV may cause kidney injury and BKV may contribute to PML.
- Systematic testing for both viruses is recommended in atypical PML or PVN cases.

## Abstract

•First Reported Case: Simultaneous PML (JCV) and PVN (BKV) in a non-transplanted patient.•Beyond Transplant Patients: Highlights the need to consider polyomavirus nephropathy in hematologic malignancies.•High Viral Loads & Cross-Organ Impact: Suggests JCV may contribute to kidney injury and BKV may play a role in PML.•Clinical Implications: Supports systematic testing for both JCV and BKV in atypical PML or PVN cases.

First Reported Case: Simultaneous PML (JCV) and PVN (BKV) in a non-transplanted patient.

Beyond Transplant Patients: Highlights the need to consider polyomavirus nephropathy in hematologic malignancies.

High Viral Loads & Cross-Organ Impact: Suggests JCV may contribute to kidney injury and BKV may play a role in PML.

Clinical Implications: Supports systematic testing for both JCV and BKV in atypical PML or PVN cases.

John Cunningham Virus (JCV) and BK Virus (BKV) are the most extensively studied Human Polyomaviruses (HPyVs), primarily associated with Progressive Multifocal Leukoencephalopathy (PML) and BKV Nephropathy (BKVN), respectively. While co-infection with these viruses has been documented in the same disease, simultaneous manifestation in distinct pathologies has not been previously reported. We present the first documented case of concurrent PML and Polyomavirus Nephropathy (PVN) due to reactivation of two different HPyVs, offering new insights into the clinical spectrum of HPyV-related diseases.

## Linked entities

- **Diseases:** Progressive multifocal leukoencephalopathy (MONDO:0016318), Polyomavirus nephropathy (MONDO:0022529)

## Full-text entities

- **Genes:** HLA-G (major histocompatibility complex, class I, G) [NCBI Gene 3135] {aka MHC-G}
- **Diseases:** AIDS (MESH:D000163), JCV (MESH:D010283), associated disease (MESH:D004194), BKV (MESH:D014777), hematologic malignancies (MESH:D019337), ureteral lesions (MESH:D014515), organ damage (MESH:D000092124), PVN (MESH:D027601), KTR (MESH:D007674), cystitis (MESH:D003556), Central Nervous System (CNS) disease (MESH:D002493), frontal syndrome (MESH:D020233), inflammatory (MESH:D007249), multiple sclerosis (MESH:D009103), inflammatory/rheumatological diseases (MESH:D012213), albuminuria (MESH:D000419), BK and JC polyomavirus co-infection (MESH:D007968), anemia (MESH:D000740), MM (MESH:D009101), ureteral strictures (MESH:D003251), acute kidney injury (MESH:D058186), -infection (MESH:D007239), JC co-infection (MESH:D060085), pleocytosis (MESH:D007964), hemorrhagic cystitis (MESH:D006470), myelinoclastic lesions (MESH:D002549), white matter lesions (MESH:D056784), BK viremia (MESH:D014766)
- **Chemicals:** natalizumab (MESH:D000069442), pomalidomide (MESH:C467566), glucose (MESH:D005947), dexamethasone (MESH:D003907), lactate (MESH:D019344), creatinine (MESH:D003404)
- **Species:** Kayvirus kay (species) [taxon 221915], Betapolyomavirus hominis (species) [taxon 1891762], Homo sapiens (human, species) [taxon 9606], Human immunodeficiency virus 1 (no rank) [taxon 11676], Polyomavirus sp. (species) [taxon 36362], Human immunodeficiency virus (species) [taxon 12721], SV40 [taxon 10633]

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC12859233/full.md

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Source: https://tomesphere.com/paper/PMC12859233