Suppr超能文献

肾移植后细小病毒B19感染

[Parvovirus B19 infection after kidney transplantation].

作者信息

Brodin-Sartorius Albane, Mekki Yahia, Bloquel Bénédicte, Rabant Marion, Legendre Christophe

机构信息

Service de transplantation rénale adulte, université Paris-Descartes, hôpital Necker, 149-161, rue de Sèvres, 75015 Paris, France.

出版信息

Nephrol Ther. 2012 Feb;8(1):5-12. doi: 10.1016/j.nephro.2011.06.001. Epub 2011 Jul 16.

Abstract

Prevalence for human parvovirus B19 infection is estimated to be between 2% and 30% in renal transplant recipients. In post-transplant settings, parvovirus B19 infection may occur either as a primary infection or a reactivation. Parvovirus transmission most commonly occurs through respiratory tract but may also result from graft or blood packs contamination. Co-infections with HHV-6 and CMV viruses are frequent. The hallmark symptom is anemia, more rarely pancytopenia and hemophagocytic syndrome. In respect to renal involvement, parvovirus B19 infection has been associated with graft dysfunction in 10% of cases. Both thrombotic microangiopathies and collapsing glomerulopathies have been reported concomitantly with parvovirus B19 infection but the causal link remains unclear. Other complications are seldomly reported, including hepatitis, encephalitis, and myocarditis. Diagnosis is based on pre and post-transplant serological status. In addition, the management of parvovirus B19 infection in immunocompromised patients requires quantitative assessment of blood viral load by PCR. The treatment relies primarily on reduction of immunosuppression combined with intravenous immunoglobulin infusions. Relapses occur in 30% of cases.

摘要

据估计,肾移植受者中人类细小病毒B19感染的患病率在2%至30%之间。在移植后环境中,细小病毒B19感染可能以原发性感染或再激活的形式出现。细小病毒最常见的传播途径是呼吸道,但也可能因移植物或血袋污染而传播。与HHV-6和CMV病毒的合并感染很常见。标志性症状是贫血,较少见全血细胞减少和噬血细胞综合征。关于肾脏受累,细小病毒B19感染在10%的病例中与移植肾功能障碍有关。血栓性微血管病和塌陷性肾小球病都曾与细小病毒B19感染同时报道,但因果关系仍不清楚。其他并发症很少报道,包括肝炎、脑炎和心肌炎。诊断基于移植前后的血清学状态。此外,免疫功能低下患者中细小病毒B19感染的管理需要通过PCR对血液病毒载量进行定量评估。治疗主要依靠减少免疫抑制并联合静脉注射免疫球蛋白。30%的病例会复发。

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验