Parvovirus B19 Infection-Related Complications in Renal Transplant Recipients

Moudgil, Asha; Shidban, Hamid; Nast, Cynthia C.; Bagga, Arvind; Aswad, S.; Graham, S.; Mendez, Robert; Jordan, Stanley C.

doi:10.1097/00007890-199712270-00037

Cited by 123 publications

(73 citation statements)

References 9 publications

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“…Parvovirus B19 infection is increasingly being implicated in the pathogenesis of glomerulopathies in native and trans-425 planted kidneys (8,20). It can present as de novo or recurrent disease.…”

Section: Introduction and Resultsmentioning

confidence: 99%

“…Here, we report the follow-up of a patient who has previously been described (8). The patient is a 53-year-old Caucasian female with autosomal dominant polycystic kidney disease progressing to end stage renal disease (ESRD).…”

Section: Introduction and Resultsmentioning

confidence: 99%

“…De novo PV-B19 has been reported in a variety of renal glomerulopathies in both native (16,17,(20)(21)(22) and transplanted kidneys (8,23), suggesting a causal relationship in acute and chronic renal failure. Disease recurrence is generally less well described (23).…”

Section: Parovirus B-19 and Kidney Transplantmentioning

confidence: 99%

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Treatment of Parvovirus B-19 (PV B-19) Infection Allows for Successful Kidney Transplantation Without Disease Recurrence

Barsoum

Bunnapradist

Mougdil

et al. 2002

American Journal of Transplantation

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Parvovirus B 19 (PV-B19) has emerged as a cause of glomerulopathy in native and transplanted kidneys. Disease recurrence is less well described. The clinical and pathological spectrum of PV-B19 infection can be quite variable and therefore easily missed. There are no data regarding the safety of transplantation in PV-B19-infected patients. We diagnosed a kidney transplant patient with recurrent PV-B19 infection and collapsing glomerulopathy (CG) on renal biopsy. Retrospective analysis of stored serum showed that PV-B19 DNA was present prior to the transplant. The patient was treated with intravenous immunoglobulin (IVIG), and eventually the virus was successfully eradicated after allograft loss and discontinuation of immunosuppressive medications. The patient subsequently received her fourth kidney transplant. Polymerase chain reaction (PCR) for PV-B19 DNA was negative on multiple occasions for approximately 1 year prior to her transplant. The patient is now 22 months post transplantation, quarterly serum PCRs continue to be negative for PV-B19 DNA despite reinstitution of immunosuppressive therapy. The patient's renal function remains stable with a serum creatinine of 0.9 mg/dL and a serum albumin of 4.2 g/dL. Successful diagnosis and treatment of PV-B19 viremia appears to allow for successful transplantation without evidence of disease recurrence. Since PV-B19 can cause significant morbidity post transplant, it is important to screen potential transplant candidates at risk for PV-B19 infection pre transplant. Careful surveillance post transplantation is necessary to identify disease recurrence so that early treatment can be initiated.

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Section: Introduction and Resultsmentioning

confidence: 99%

Section: Introduction and Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of Parvovirus B-19 (PV B-19) Infection Allows for Successful Kidney Transplantation Without Disease Recurrence

Barsoum

Bunnapradist

Mougdil

et al. 2002

American Journal of Transplantation

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“…A dose de IVIG recomendada pela maioria dos estudos é de 0,4/kg/dia durante 5 dias, havendo extensos debates com a relação à melhor dose a ser utilizada e ao potencial de sucesso destas na erradicação da viremia. 2,7,27,28 Na maioria dos relatos encontrados na literatura, observa-se resposta clínica, ainda que com raros relatos acerca da erradicação da viremia, ressaltando que esta não foi avaliada na grande maioria dos casos. 2 Não se sabe se a persistência da viremia está associada à recorrência clínica ou qual o impacto desta na morbidade do paciente.…”

Section: Discussionunclassified

Posttransplant chronic anemia: parvovirus B19

Vincens¹,

Carminatti²,

Franco³

et al. 2012

Jornal Brasileiro De Nefrologia

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A anemia é frequente em pacientes após o transplante renal (TxR) e sua prevalência varia conforme o tempo pós-transplante e os critérios diagnós-ticos empregados. A infecção pelo Parvovírus B19 (PV B19) é causa subdiagnosticada de anemia nesta população. Para ilustrar a epidemiologia e espectro clínico, apresentamos caso de PV B19 que evoluiu com aplasia pura de série vermelha (APSV), ressaltando as dificuldades do diagnóstico e tratamento. O emprego da detecção do DNA viral pela reação em cadeia da polimerase e do diagnóstico das alterações da morfologia da medula óssea são particularmente úteis para o diagnóstico no paciente transplantado imunossuprimido que falha na produção da resposta humoral contra o PV B19.Anemia is frequent in kidney transplant patients, and its prevalence varies according to posttransplant time and the adopted diagnostic criteria. Parvovirus B19 (PV B19) infection is an underdiagnosed cause of anemia in this particular population. To illustrate epidemiologic and clinical data regarding it, we present a case of PV B19 infection complicated by pure red cell aplasia (PRCA), pointing out the pitfalls we encountered in diagnosis and treatment. The use of viral DNA detection by polymerase chain reaction (PCR), and correct interpretation of morphological features of bone marrow histology are particularly important for the diagnosis of this condition in kidney transplant patients, who fail to develop a proper humoral response against PV B19, thus importantly decreasing the sensitivity of serological methods in this setting. Anemia crônica no pós-transplante renal: parvovirose B19Posttransplant chronic anemia: parvovirus B19 ResumoPalavras-chave: anemia, aplasia pura de série vermelha, imunoglobulinas intravenosas, parvovirus B19 humano, transplante de rim. AbstRAct

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“…The molecular mechanism whereby parvovirus B19 causes anemia is known: the virus replicates in proliferating and differentiating erythroid precursors and causes RBC aplasia by inducing RBC precursor apoptosis (37,38). The virus binds to the erythrocyte P-antigen, its cellular membrane ligand, and causes apoptosis of erythrocyte progenitors via the NS1-caspase pathway with a subsequent arrest in erythropoiesis (37,39). Because parvovirus B19 antibodies are prevalent in the normal population, diagnosis is made using parvovirus-PCR DNA detection.…”

Section: Infectionsmentioning

confidence: 99%