Immunoglobulin Abnormalities in Renal Transplant Recipients

Pollock, Carol; Mahony, J. F.; Ibels, L. S.; Caterson, Robyn J.; Waugh, David A.; Wells, J. Vivian; Sheil, A. G. R.

doi:10.1097/00007890-198906000-00007

Cited by 50 publications

(40 citation statements)

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“…One of the other two false-negative patients was undergoing immunosuppression therapy for a renal transplant, which could potentially cause a false-negative result on an antibody detectionbased assay due to a decrease in IgG levels (5,8,18). The final patient had no history that would explain a negative antibody result.…”

Section: Discussionmentioning

confidence: 97%

Antituberculosis IgG Antibodies as a Marker of Active Mycobacterium tuberculosis Disease

Welch¹,

Lawless²,

Litwin³

2012

Clin. Vaccine Immunol.

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ABSTRACTAnti-Mycobacterium tuberculosisIgG antibodies may aid in the diagnosis of activeM. tuberculosisdisease. We studied whether anti-M. tuberculosisIgG antibodies are elevated in activeM. tuberculosisdisease and assessed factors contributing to false-positive and -negative results. A retrospective study of 2,150 individuals tested by the QuantiFERON-TB Gold In-Tube (QFT-GIT) assay was conducted at the University of Utah, ARUP Laboratories, November 2008 to December 2010. All samples were tested with the InBios Active TbDetectantituberculosis (anti-TB) IgG antibody assay. Of 1,044 patients with a positive QFT-GIT, 59 (5.7%) were positive forM. tuberculosisantibodies. Fourteen of 1,106 (1.3%) with a negative or indeterminate QFT-GIT were positive forM. tuberculosisantibodies.M. tuberculosisantibody tests were positive in 61.5% with confirmed activeM. tuberculosisdisease and other mycobacterial infections. Over half of the false-negativeM. tuberculosisantibody tests occurred in patients ≥90 years of age. False positives were seen in 12.9% of autoimmune patients. The odds ratio of being positive by the QFT-GIT and the InBios TB IgG assay increased with confirmedM. tuberculosisdisease or highly suspectedM. tuberculosisdisease and was 86.7 (95% confidence interval [CI], 34.4 to 218.5) in these two groups compared to patients negative by both tests. Although anti-M. tuberculosisantibodies can be detected in patients with activeM. tuberculosisdisease, caution should be used with patients where immunoglobulin levels may be decreased or patients with autoantibodies.

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Section: Discussionmentioning

confidence: 97%

Antituberculosis IgG Antibodies as a Marker of Active Mycobacterium tuberculosis Disease

Welch¹,

Lawless²,

Litwin³

2012

Clin. Vaccine Immunol.

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“…The presence of HGG of any class at month 1 was independently associated with the incidence of bacterial infection during the intermediate posttransplant period, whereas HGG at month 6 was associated with either overall infection or bacterial infection in the late period. The literature contains some studies aimed at assessing the incidence and relevance of HGG after KT (12)(13)(14)(15). Most of them, however, were performed more than a decade ago (12)(13)(14), thus limiting the validity of their findings in the setting of contemporary immunosuppressive and prophylactic practices, or were based on small sample sizes (13,14).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally the immunosuppressive drugs required to prevent allograft rejection contribute to the development of acquired hypogammaglobulinemia (HGG) in kidney transplant (KT) recipients (9)(10)(11). Only a few previous studies have evaluated the impact of humoral immune function on the risk of infection after KT (12)(13)(14)(15). We undertook the present work to prospectively assess the incidence, timing, predisposing factors and clinical significance of HGG in KT recipients.…”

Section: Introductionmentioning

confidence: 99%

Monitoring of Immunoglobulin Levels Identifies Kidney Transplant Recipients at High Risk of Infection

Fernández‐Ruiz

López‐Medrano

Varela-Peña

et al. 2012

American Journal of Transplantation

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“…Of particular importance appears to be the presence of posttransplantation hypogammaglobulinemia. This phenomenon, described in heart, kidney, and lung recipients, has been associated with the development of recurrent infections (42,84,102). In the study by Goldfarb et al, patients with hypogammaglobulinemia (immunoglobulin G Ͻ 600 mg/dl) lacked protective response to pneumococcus in 30%, diphtheria in 15%, and tetanus in 19%.…”

Section: General Principlesmentioning

confidence: 99%

Vaccinations for Adult Solid-Organ Transplant Recipients: Current Recommendations and Protocols

Duchini¹,

Goss²,

et al. 2003

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Recipients of solid-organ transplantation are at risk of severe infections due to their life-long immunosuppression. Despite emerging evidence that vaccinations are safe and effective among immunosuppressed patients, most vaccines are still underutilized in these patients. The efficacy, safety, and protocols of several vaccines in this patient population are poorly understood. Timing of vaccination appears to be critical because response to vaccinations is decreased in patients with end-stage organ disease and in the first 6 months after transplantation. For these reasons, the primary immunizations should be given before transplantation, as early as possible during the course of disease. Vaccination strategy should include vaccination of household contacts and health care workers at transplant centers unless contraindicated. No conclusive data are available on the use of immunoadjuvants and screening for protective titers. Most vaccines appear to be safe in solid-organ transplantation recipients, but live vaccines should be avoided until further studies are available. The risk of rejection appears minimal. Recommended vaccines include pneumovax, hepatitis A and B, influenza, and tetanus-diphtheria. We outline specific protocols and recommendations in this particular patient population. Specific contraindications exist for other vaccines, such as yellow fever, oral polio vaccine, bacillus Calmette-Guerin, and vaccinia. We conclude that solid-organ recipients will benefit from consistent immunization practices. Further studies are recommended to improve established protocols in this patient population

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Immunoglobulin Abnormalities in Renal Transplant Recipients

Cited by 50 publications

References 0 publications

Antituberculosis IgG Antibodies as a Marker of Active Mycobacterium tuberculosis Disease

Antituberculosis IgG Antibodies as a Marker of Active Mycobacterium tuberculosis Disease

Monitoring of Immunoglobulin Levels Identifies Kidney Transplant Recipients at High Risk of Infection

Vaccinations for Adult Solid-Organ Transplant Recipients: Current Recommendations and Protocols

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