Nishiyama Kei, Watanabe Yuka, Ishimura Masataka, Tetsuhara Kenichi, Imai Takashi, Kanemasa Hikaru, Ueki Kenji, Motomura Yoshitomo, Kaku Noriyuki, Sakai Yasunari, Imadome Ken-Ichi, Ohga Shouichi
Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Pediatric Intensive Care Unit, Kyushu University Hospital, Fukuoka, Japan.
Open Forum Infect Dis. 2020 Jul 6;7(8):ofaa288. doi: 10.1093/ofid/ofaa288. eCollection 2020 Aug.
Human parvovirus B19 (B19V) causes glomerulopathy or microangiopathy, but not tubulopathy. We experienced an 11-year-old girl with spherocytosis who developed acute kidney injury on a primary infection of B19V. She presented with anuria, encephalopathy, thrombocytopenia, and coagulopathy, along with no apparent aplastic crisis.
Continuous hemodiafiltration, immunoglobulin, and intensive therapies led to a cure.
A kidney biopsy resulted in a histopathological diagnosis of tubulointerstitial nephritis without immune deposits. The virus capsid protein was limitedly expressed in the tubular epithelial cells with infiltrating CD8-positive cells.
Viral and histopathological analyses first demonstrated B19-infected tubulointerstitial nephritis due to the aberrant viremia with hereditary spherocytosis.
人细小病毒B19（B19V）可导致肾小球病或微血管病，但不会引起肾小管病。我们遇到一名11岁的球形红细胞增多症女孩，在初次感染B19V时发生了急性肾损伤。她表现为无尿、脑病、血小板减少和凝血病，且无明显再生障碍危象。
持续血液透析滤过、免疫球蛋白及强化治疗使其治愈。
肾活检组织病理学诊断为无免疫沉积物的肾小管间质性肾炎。病毒衣壳蛋白在浸润有CD8阳性细胞的肾小管上皮细胞中有限表达。
病毒学和组织病理学分析首次证实，由于遗传性球形红细胞增多症伴异常病毒血症导致B19感染性肾小管间质性肾炎。
