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A Serological Study of Human Polyomavirus BK (BKV) in Patients with Nephrotic Syndrome ‐ Detection of BKV‐Specific IgM Antibody

In 38 nephrotic syndrome patients, 21.1% (8/38) of the patients had high BKV‐HI titers of 1:640 or higher and this incidence was much greater (p<0.001) than that of healthy controls (2.1%; 11/548), diabetes mellitus patients (2.1%; 2/94), and pregnant women (3.4%; 6/176). A higher incidence (15.8%; 6/38) of CF antibody titers, more than 1:16, was also observed in nephrotic syndrome patients in comparison to age‐matched healthy controls (3.2%; 7/220, p<0.005). In the sequential study of BK antibodies in 13 patients with nephrotic syndrome over a period of 16 months, we found one case where the CF titer developed from 1:4 to 1:64 and the titers of 1:32 to 1:64 lasted for 6 months (observation period). Long‐lasting high CF titers were also shown in 2 other patients where the CF titer of 1:32 to 1:64 lasted for more than 16 months. BKV‐specific IgM antibody was screened in 4 patients by 2‐ME treatment of IgM fractions of the sera which had high CF titers and 2 of these 4 patients revealed the IgM antibody. Although the detected IgM HI‐antibody titers were low (1:2 to 1:16), the IgM antibody could be confirmed by immune electron microscopy. From a serological view, BKV‐specific IgM antibody detected in the patients with nephrotic syndrome seemed to be a result of reactivation of a latent vids. There was no obvious association between the serological findings and frequency of relapse (albuminuria).