小儿肾移植患者BK病毒感染的临床表现

Yiyoung Kwon, Jeong Yeon Kim, Yeonhee Lee, Heeyeon Cho
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引用次数: 6

摘要

多瘤病毒BK (BKV)感染是肾移植患者移植物丢失的重要原因。目的本研究的目的是评估肾移植后儿科患者BKV的临床表现和危险因素。方法回顾性单中心研究纳入2002年1月至2017年12月31例儿童肾移植受者。2例患者在研究期间接受了2例移植,每次移植均独立分析。病例数33例,患者31例。通过定期定量聚合酶链反应从血样中确认BKV感染。结果肾移植患者平均年龄为11.0±4.7岁,男女比例为2.7:1。3例患者既往有大剂量化疗和自体干细胞移植治疗实体瘤的病史。9例(27.3%)发生BKV感染。从肾移植到血液中检测到BKV的中位时间为5.6个月。BKV感染患者和未感染患者的肾小球滤过率估计无统计学差异。在9例BKV病毒血症患者中,通过减少免疫抑制剂剂量治疗7例,其中6例BKV被清除。在另外2例bkv阳性患者中,病毒血症得到改善,但免疫抑制剂未减少。结论BKV感染在肾移植患儿中很常见,由于BKV检测时早期免疫抑制剂减少,可能不会影响患者的短期肾功能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical manifestations of BK virus infection in pediatric kidney transplant patients
Background Polyomavirus BK (BKV) infection is an important cause of graft loss in kidney transplant patients. Purpose The purpose of this study was to evaluate clinical findings and risk factors for BKV in pediatric patients after kidney transplantation. Methods This retrospective single-center study included 31 pediatric kidney transplant recipients from January 2002 to December 2017. Two patients received 2 transplantations during the study period, and each transplant was analyzed independently. Total number of cases is 33 cases with 31 patients. BKV infection was confirmed from blood samples via periodic quantitative polymerase chain reaction. Results The mean age at kidney transplantation was 11.0±4.7 years, and the male-to-female ratio was 2.7:1. Three patients had a past medical history of high-dose chemotherapy and autologous stem-cell transplantation for solid tumors. Nine patients (27.3%) developed BKV infection. The median period from kidney transplantation to BKV detection in blood was 5.6 months. There was no statistically significant difference in estimated glomerular filtration rate between patients with and those without BKV infection. Among 9 patients with BKV viremia, 7 were treated by reducing their immunosuppressant dose, and BKV was cleared in 6 of these 7 patients. In the other 2 BKV-positive patients, viremia improved without immunosuppressant reduction. Conclusion BKV infection is common in children with kidney transplantation and might not have affected short-term renal function in our patient sample due to early immunosuppressant reduction at the time of BKV detection.
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来源期刊
自引率
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0
审稿时长
12 weeks
期刊介绍: Korean J Pediatr covers clinical and research works relevant to all aspects of child healthcare. The journal aims to serve pediatricians through the prompt publication of significant advances in any field of pediatrics and to rapidly disseminate recently updated knowledge to the public. Additionally, it will initiate dynamic, international, academic discussions concerning the major topics related to pediatrics. Manuscripts are categorized as review articles, original articles, and case reports. Areas of specific interest include: Growth and development, Neonatology, Pediatric neurology, Pediatric nephrology, Pediatric endocrinology, Pediatric cardiology, Pediatric allergy, Pediatric pulmonology, Pediatric infectious diseases, Pediatric immunology, Pediatric hemato-oncology, Pediatric gastroenterology, Nutrition, Human genetics, Metabolic diseases, Adolescence medicine, General pediatrics.
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