Conclusions: Not only is this an unusual case of polyomavirus BK virus nephropathy in the native kidney with a strikingly high BK load of 10 8 , but it is also the first reported association of BK virus nephropathy with thrombotic microangiopathy in a patient with no prior transplantation history and no active immunosuppression regimen. This case highlights the importance of considering BK virus nephropathy in the differential diagnosis of kidney dysfunction not only among transplant recipient but in all immunocompromised hosts including B-cell depleting regimens. If left untreated, we believe that high BK viral loads can become clinically symptomatic and cause endothelial dysfunction resulting in renal TMA as we described here for the first time. More studies are needed to define the best therapeutic approach to BK virus nephropathy in non-transplant patients.

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Introduction: Acute post-infectious glomerulonephritis is caused by a non-suppurative inflammatory reaction resulting from an immune response to an infection. we will study the epidemiological, clinical and paraclinical characteristics of acute post-infectious glomerulonephritis in adults Methods: We have conducted a retrospective study; including 54 patients diagnosed with acute post-infectious glomerulonephritis. Results: The median age was 37.5 years, the sex ratio was 4.4 (H/F). The percentage of patients with a history of diabetes was 7.4%, hypertension 7.4%, history of recurrent angina 10%. The initial clinical presentations were variable: the oedematous syndrome was presented by 48.1% of patients, 22.2% for acute nephritic syndrome, 11.1% for advanced renal failure, 7.4% for impure nephrotic syndrome, 5.6% for renal failure. The percentage of patients who presented an infectious episode preceding the initial symptomatology with a variable free interval is 72.2%. The most frequent site of infection was upper respiratory tract (37%), the percentage of lower lung infections was 11.1%, 9.3% for skin infections, 7.4% for urinary tract infections, and 33.3% of patients had no infectious site.The median systolic and diastolic blood pressure was 152 mmHg and 88.7 mmHg respectively. For the evolution of arterial hypertension: 55.6% of patients have a balanced blood pressure under treatment and 38.9% without treatment; in 5.6% of patients the control was not done.The median creatinine and proteinuria of 24 hour on admission was 150 mmol and 2.6 g/24h respectively. The percentage of patients who presented a persistence of urinary sediment abnormalities during surveillance was 62.5% for hematuria and proteinuria at the urinary strip. It was noted that 25.9% of patients presented a persistence of proteinuria of 24 hours. All patients have benefited renal puncture biopsy which showed endocapillary and extracapillary proliferation in 9 patients (22.5%).End-stage renalfailure was noted in 7.5% of patients, 2.5% for stage 3 CKD, 7.5% for stage 2 CKD and 60% for stage 1 CKD. Conclusions: The clinical and evolution symptoms of acute post-infectious glomerulonephritis in adults were variable and different from those in children.No conflict of interest