medigraphic.com
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2019, Number 4

<< Back Next >>

Rev Invest Clin 2019; 71 (4)

Treatment Strategies and Outcome of Parvovirus B19 Infection in Kidney Transplant Recipients: A Case Series and Literature Review of 128 Patients

Rosado-Canto R, Carrillo-Pérez DL, Jiménez JV, Cuellar-Rodríguez J, Parra-Avila I, Alberú J, Morales-Buenrostro LE

Language: English
References: 57
Page: 265-274
PDF size: 154.31 Kb.


ABSTRACT

Background: There is no specific antiviral treatment for parvovirus B19 (PVB19) infection. Objective: The objective of this study was to study the treatment and outcome of PVB19 infection in kidney transplant recipients (KTR) at our institution, and cases published in the medical literature. Methods: We conducted a retrospective review of PVB19 infection in KTR at an academic medical center over a 16-year period and summarized the data on its treatment and outcome in 120 KTR in the medical literature. Results: In our cohort of eight patients, the median time to the onset of PVB19 disease was 7.2 weeks after transplantation. All patients had severe aregenerative anemia (mean hemoglobin (Hb) of 6.2 ± 1.0 g/dl); all were treated with a reduction in their immunosuppressive regimen and the administration of single-dose intravenous immunoglobulin (IVIG) (mean total dosage of 0.87 ± 0.38 g/kg). The median time to anemia improvement (Hb ›10 g/dl) was 3-week post-treatment. No recurrences were documented during follow-up (median 25 months). Among 128 patients (including our cohort of 8 and 120 reported in literature), therapeutic strategies included: 43% IVIG alone, 39% IVIG and reduced immunosuppression, 9% reduction of immunosuppression, and 9% conservative therapy. Clinical relapses were observed in 35% of 71 reported cases. Conclusions: In KTR, decreasing immunosuppression and the administration of low-dose immunoglobulin seem to be not worse than the standard dose in PVB19 infection.


REFERENCES

  1. Porignaux R, Vuiblet V, Barbe C, Nguyen Y, Lavaud S, Toupance O, et al. Frequent occurrence of parvovirus B19 DNAemia in the first year after kidney transplantation. J Med Virol. 2013; 85:1115-21.

  2. Kurtzman G, Frickhofen N, Kimball J, Jenkins DW, Nienhuis AW, Young NS, et al. Pure red-cell aplasia of 10 years' duration due to persistent parvovirus B19 infection and its cure with immunoglobulin therapy. N Engl J Med. 1989;321:519-23.

  3. Eid AJ, Brown RA, Patel R, Razonable RR. Parvovirus B19 infection after transplantation: a review of 98 cases. Clin Infect Dis. 2006;43:40-8.

  4. Shimmura H, Tanabe K, Ishikawa N, Tokumoto T, Toda F, Toma H, et al. Discontinuation of immunosuppressive antimetabolite for parvovirus B19-associated anemia in kidney transplant patients. Transplant Proc. 2000;32:1967-70.

  5. Eid AJ, Chen SF, AST Infectious Diseases Community of Practice. Human parvovirus B19 in solid organ transplantation. Am J Transplant. 2013;13 Suppl 4:201-5.

  6. Baek CH, Kim H, Yang WS, Han DJ, Park SK. Risk factors and long-term outcomes of parvovirus B19 infection in kidney transplant patients. Transpl Infect Dis. 2017;19:e12754.

  7. Malbora B, Saritas S, Ataseven E, Belen B, Alparslan C, Yavascan O, et al. Pure red cell aplasia due to parvovirus B19: erythropoietin- resistant anemia in a pediatric kidney recipient. Exp Clin Transplant. 2017;15:369-71.

  8. Parodis López Y, Santana Estupiñán R, Marrero Robayna S, Gallego Samper R, Henríquez Palop F, Rivero Vera JC, et al. Anaemia and fever in kidney transplant. The role of human parvovirus B19. Nefrologia. 2017;37:206-12.

  9. Rivas-Delgado A, Matutes E, Rozman M. Recurrent pure red cell aplasia in a hepatorenal transplant recipient with chronic parvovirus B19 infection. Br J Haematol. 2016;172:495.

  10. Alves MT, Vilaça SS, Carvalho Md, Fernandes AP, Dusse LM, Gomes KB, et al. Human parvovirus B19 infection in a renal transplant recipient: A case report. BMC Res Notes. 2013;6:28.

  11. Crabol Y, Terrier B, Rozenberg F, Pestre V, Legendre C, Hermine O, et al. Intravenous immunoglobulin therapy for pure red cell aplasia related to human parvovirus b19 infection: A retrospective study of 10 patients and review of the literature. Clin Infect Dis. 2013;56:968-77.

  12. Gosset C, Viglietti D, Hue K, Antoine C, Glotz D, Pillebout E, et al. How many times can parvovirus B19-related anemia recur in solid organ transplant recipients? Transpl Infect Dis. 2012; 14:E64-70.

  13. Tavera M, Petroni J, León L, Minue E, Casadei D. Reactive haemophagocytic syndrome associated with parvovirus B19 in a kidney-pancreas transplant patient. Nefrologia. 2012;32:125-6.

  14. Labbadia F, Salido-Fierréz E, Majado-Martinez J, Cabañas-Perianes V, Moraleda JJ. Pure red cell aplasia in a simultaneous pancreas-kidney transplantation patient: inside the erythroblast. Hematol Rep. 2012;4:e17.

  15. Kurukulasuriya A, Hamed AA, Al-Muslahi M, Ibrahim A. Acquired pure red cell aplasia caused by parvovirus B19 infection following a renal transplant. Sultan Qaboos Univ Med J. 2011; 11:280-3.

  16. León LR, Curcio D, Casadei D. Parvovirus B19 infection: diagnosing and treating a kidney transplant patient. Nefrologia. 2010; 30:704.

  17. Shen Q, Xu H, Cao Q, Zhou LJ, Xu J, Fang XY, et al. Long-term remission of recurrent severe anemia as a result of parvovirus B19 infection in a pediatric renal transplant recipient. Pediatr Transplant. 2011;15:E76-9.

  18. Ardalan MR, Shoja MM, Tubbs RS, Jayne D. Parvovirus B19 microepidemic in renal transplant recipients with thrombotic microangiopathy and allograft vasculitis. Exp Clin Transplant. 2008;6:137-43.

  19. Ardalan MR, Shoja MM, Tubbs RS, Esmaili H, Keyvani H. Postrenal transplant hemophagocytic lymphohistiocytosis and thrombotic microangiopathy associated with parvovirus b19 infection. Am J Transplant. 2008;8:1340-4.

  20. Pinto V, Grandy J, Zambrano P, Corta B, Salas P, Salgado I, et al. Severe anemia from parvovirus b19 infection in pediatric renal transplant recipients: two case reports. Transplant Proc. 2008; 40:3261-4.

  21. Beckhoff A, Steffen I, Sandoz P, Hirsch HH, Schaub S. Relapsing severe anaemia due to primary parvovirus B19 infection after renal transplantation: a case report and review of the literature. Nephrol Dial Transplant. 2007;22:3660-3.

  22. Arzouk N, Snanoudj R, Beauchamp-Nicoud A, Mourad G, Charpentier B, Tchernia G, et al. Parvovirus B19-induced anemia in renal transplantation: a role for rHuEPO in resistance to classical treatment. Transpl Int. 2006;19:166-9.

  23. Renoult E, Bachelet C, Krier-Coudert MJ, Diarrassouba A, André JL, Kessler M, et al. Recurrent anemia in kidney transplant recipients with parvovirus B19 infection. Transplant Proc. 2006; 38:2321-3.

  24. Laurenz M, Winkelmann B, Roigas J, Zimmering M, Querfeld U, Müller D, et al. Severe parvovirus B19 encephalitis after renal transplantation. Pediatr Transplant. 2006;10:978-81.

  25. Egbuna O, Zand MS, Arbini A, Menegus M, Taylor J. A cluster of parvovirus B19 infections in renal transplant recipients: a prospective case series and review of the literature. Am J Transplant. 2006;6:225-31.

  26. Vales-Albertos LJ, García-Cárdenas M, Chávez-Becerra S, Gómez- Navarro B, Monteón-Ramos F, Cueto-Manzano AM, et al. Pure red cell aplasia associated with parvovirus B19 infection in renal transplantation: the first case report in Mexico. Transplantation. 2005;79:739.

  27. Bilge I, Sadiko˘glu B, Emre S, Sirin A, Aydin K, Tatli B, et al. Central nervous system vasculitis secondary to parvovirus B19 infection in a pediatric renal transplant patient. Pediatr Nephrol. 2005; 20:529-33.

  28. Subtirelu MM, Flynn JT, Schechner RS, Pullman JM, Feuerstein D, Del Rio M, et al. Acute renal failure in a pediatric kidney allograft recipient treated with intravenous immunoglobulin for parvovirus B19 induced pure red cell aplasia. Pediatr Transplant. 2005;9:801-4.

  29. Ki CS, Kim IS, Kim JW, Lee NY, Kim SH, Lee KW, et al. Incidence and clinical significance of human parvovirus B19 infection in kidney transplant recipients. Clin Transplant. 2005;19:751-5.

  30. Kumar J, Shaver MJ, Abul-Ezz S. Long-term remission of recurrent parvovirus-B associated anemia in a renal transplant recipient induced by treatment with immunoglobulin and positive seroconversion. Transpl Infect Dis. 2005;7:30-3.

  31. Gómez Huertas E, Melón S, Laurés AS, de Oña M, Alvarez- Grande J. Parvovirus B9 infection in a renal transplant recipient. Diagnosis by detection of viral genome in peripheral blood. Nefrologia. 2005;25:67-72.

  32. Rerolle JP, Morelon E, Helal I, Peraldi MN, Mamzer-Bruneel MF, Kreis H, et al. Parvovirus B19-related anaemia after renal transplantation. Scand J Infect Dis. 2004;36:513-6.

  33. Garewal G, Ahluwalia J, Varma N, Das R, Sakhuja VK. Parvovirus B19 infection-associated red-cell aplasia in renal-transplant recipients: clues from the bone marrow. Transplantation. 2004;77:320-1.

  34. Liefeldt L, Buhl M, Schweickert B, Engelmann E, Sezer O, Laschinski P, et al. Eradication of parvovirus B19 infection after renal transplantation requires reduction of immunosuppression and high-dose immunoglobulin therapy. Nephrol Dial Transplant. 2002;17:1840-2.

  35. Yango A Jr., Morrissey P, Gohh R, Wahbeh A. Donor-transmitted parvovirus infection in a kidney transplant recipient presenting as pancytopenia and allograft dysfunction. Transpl Infect Dis. 2002;4:163-6.

  36. Choi SH, Chang SP, Won JC, Lee JS, Chi HS, Yang WS, et al. A case of persistent anemia in a renal transplant recipient: association with parvovirus B19 infection. Scand J Infect Dis. 2002;34:71-5.

  37. Shan YS, Lee PC, Wang JR, Tsai HP, Sung CM, Jin YT, et al. Fibrosing cholestatic hepatitis possibly related to persistent parvovirus B19 infection in a renal transplant recipient. Nephrol Dial Transplant. 2001;16:2420-2.

  38. Lui SL, Luk WK, Cheung CY, Chan TM, Lai KN, Peiris JS, et al. Nosocomial outbreak of parvovirus B19 infection in a renal transplant unit. Transplantation. 2001;71:59-64.

  39. Murer L, Zacchello G, Bianchi D, Dall’Amico R, Montini G, Andreetta B, et al. Thrombotic microangiopathy associated with parvovirus B 19 infection after renal transplantation. J Am Soc Nephrol. 2000;11:1132-7.

  40. Geetha D, Zachary JB, Baldado HM, Kronz JD, Kraus ES. Pure red cell aplasia caused by parvovirus B19 infection in solid organ transplant recipients: a case report and review of literature. Clin Transplant. 2000;14:586-91.

  41. So BJ, Chae KM, Lee KK, Lee YJ, Jeong BH. Pure red cell aplasia due to parvovirus B19 infection in a renal transplant patient: a case report. Transplant Proc. 2000;32:1954-6.

  42. Lee PC, Hung CJ, Lei HY, Chang TT, Wang JR, Jan MS, et al. Parvovirus B19-related acute hepatitis in an immunosuppressed kidney transplant. Nephrol Dial Transplant. 2000; 15:1486-8.

  43. Pamidi S, Friedman K, Kampalath B, Eshoa C, Hariharan S. Human parvovirus B19 infection presenting as persistent anemia in renal transplant recipients. Transplantation. 2000;69:2666-9.

  44. Wong TY, Chan PK, Leung CB, Szeto CC, Tam JS, Li PK, et al. Parvovirus B19 infection causing red cell aplasia in renal transplantation on tacrolimus. Am J Kidney Dis. 1999; 34:1132-6.

  45. Marchand S, Tchernia G, Hiesse C, Tertian G, Cartron J, Kriaa F, et al. Human parvovirus B19 infection in organ transplant recipients. Clin Transplant. 1999;13:17-24.

  46. Keung YK, Chuahirun T, Wesson D. Concomitant parvovirus B19 and cytomegalovirus infections after living-related renal transplantation. Nephrol Dial Transplant. 1999;14:469-71.

  47. Moudgil A, Shidban H, Nast CC, Bagga A, Aswad S, Graham SL, et al. Parvovirus B19 infection-related complications in renal transplant recipients: treatment with intravenous immunoglobulin. Transplantation. 1997;64:1847-50.

  48. Mathias RS. Chronic anemia as a complication of parvovirus B19 infection in a pediatric kidney transplant patient. Pediatr Nephrol. 1997;11:355-7.

  49. Ahsan N, Holman MJ, Gocke CD, Groff JA, Yang HC. Pure red cell aplasia due to parvovirus B19 infection in solid organ transplantation. Clin Transplant. 1997;11:265-70.

  50. Bertoni E, Rosati A, Zanazzi M, Azzi A, Zakrzewska K, Guidi S, et al. Aplastic anemia due to B19 parvovirus infection in cadaveric renal transplant recipients: an underestimated infectious disease in the immunocompromised host. J Nephrol. 1997; 10:152-6.

  51. Sturm I, Watschinger B, Geissler K, Guber SE, Popow-Kraupp T, Horl WH, et al. Chronic parvovirus B19 infection-associated pure red cell anaemia in a kidney transplant recipient. Nephrol Dial Transplant. 1996;11:1367-70.

  52. Uemura N, Ozawa K, Tani K, Nishikawa M, Inoue S, Nagao T, et al. Pure red cell aplasia caused by parvovirus B19 infection in a renal transplant recipient. Eur J Haematol. 1995;54:68-9.

  53. Al-Khaldi N, Watson AR, Harris A, Irving WL. Dual infection with human herpesvirus Type 6 and parvovirus B19 in a renal transplant recipient. Pediatr Nephrol. 1994;8:349-50.

  54. Waldman M, Kopp JB. Parvovirus-B19-associated complications in renal transplant recipients. Nat Clin Pract Nephrol. 2007; 3:540-50.

  55. The World Bank. Available from: http://www.worldbank.org/ en/access-to-information. [Last accessed on 2018 Nov 26].

  56. Depasse JW, Lee PT. A model for ‘reverse innovation’ in health care. Glob Health. 2013;9:40.

  57. Cavallo R, Merlino C, Re D, Bollero C, Bergallo M, Lembo D, et al. B19 virus infection in renal transplant recipients. J Clin Virol. 2003;26:361-8.




2020     |     www.medigraphic.com