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- Title
Acute renal failure in a pediatric kidney allograft recipient treated with intravenous immunoglobulin for parvovirus B19 induced pure red cell aplasia.
- Authors
Subtirelu, Mihail M.; Flynn, Joseph T.; Schechner, Richard S.; Pullman, James M.; Feuerstein, Dianne; Rio, Marcela Del
- Abstract
Infection with parvovirus B19 (PV-B19) after solid organ transplantation may cause pure red cell aplasia (PRCA). Intravenous immunoglobulin (IVIg) may be of benefit in clearing the infection. Acute renal failure is a known adverse effect of IVIg administration. A 14-yr-old male received a cadaveric renal transplant. Three weeks after surgery he developed symptomatic anemia (hemoglobin 4.5 g/dL, reticulocyte count 0.2%). Anti-PV-B19 IgM and IgG titers, which had been negative pretransplant, were positive. He received two IVIg infusions as treatment for the PV-B19 infection. Four days after the IVIg infusions he developed non-oliguric acute renal failure (ARF) with a rise in serum creatinine from 1 to 1.8 mg/dL. Allograft biopsy showed changes consistent with an osmotic load. Anemia and the renal failure resolved after transfusions and IVIg. PV-B19 infection in immunosuppressed transplant recipients is associated with significant morbidity and may respond to IVIg therapy. High sucrose IVIg preparations may be associated with renal failure in renal allograft recipients. Adding PV-B19 testing of the donor and recipient to the standard pretransplant evaluation may be beneficial in diagnosing and managing a potential infection. If IVIg is to be used it may be safer to use a sucrose-free IVIg preparation.
- Subjects
ACUTE kidney failure in children; KIDNEY surgery; IMMUNOGLOBULINS; PURE red cell aplasia; APLASTIC anemia; PARVOVIRUSES
- Publication
Pediatric Transplantation, 2005, Vol 9, Issue 6, p801
- ISSN
1397-3142
- Publication type
Article
- DOI
10.1111/j.1399-3046.2005.00379.x