ABSTRACT
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.
Subject(s)
Humans , Male , Female , Young Adult , Kidney Transplantation/methods , Immunoglobulins, Intravenous/administration & dosage , Erythema Infectiosum/therapy , Immunosuppressive Agents/administration & dosage , Recurrence , Retrospective Studies , Follow-Up Studies , Treatment Outcome , Erythema Infectiosum/etiology , Academic Medical CentersABSTRACT
Human parvovirus B19, the causative agent of fifth disease in childhood, is non-enveloped DNA virus and resistant to many physicochemical agents. B19 is a potential risk to hemophiliac patients receiving blood products. To determine the prevalence of the corresponding antibody in patients with hemophilia A or B or Von Will brand's disease [VWBD], we tested 180 hemophilia patients aged 1-45 years for anti B19 IgG. This work was descriptive, cross-sectional study. The results were compared with those of 400 age-matched controls, male blood donors and male children [18-45 and 3-17 years of age, respectively]. The overall prevalence of B19 IgG in the hemophilia patients was 74% [133/180], and in the controls 56.5% [226/400, P<0.001]. The significant difference in prevalence of B19 IgG between hemophiliacs and healthy persons demonstrated that there was a high risk of transmission of parvovirus B19 through plasma- derived clotting products. These observations demonstrate that parvovirus B19 is frequently transmitted in blood products. Existing virus-inactivating methods do not prevent transmission
Subject(s)
Humans , Immunoglobulin G , Antibodies , Hemophilia A , Hemophilia B , von Willebrand Diseases , DNA Viruses , Blood Component Transfusion , Erythema Infectiosum/etiology , Hydrops Fetalis/etiology , Joint DiseasesSubject(s)
Humans , Female , Erythema Infectiosum/etiology , Parvovirus B19, Human , Fetus , Fetal Death , Abortion, Spontaneous , Parvoviridae InfectionsABSTRACT
O presente trabalho registra caso de histoplasmose em paciente de 5 anos, HIV negativo, natural e procedente da cidade da Sao Paulo, com lesoes cutaneas nao diagnosticadas clinicamente. Exame histopatologico negativo para infeccao fungica. Cultivos em duas ocasioes, positivos para Histoplasma capsulatum var. capsulatum (amostras 361 e 387). Sorologia negativa para anticorpos anti-Histoplasma capsulatum e Paracoccidioides brasiliensis pelas provas de Imunodifusao dupla e ...
Subject(s)
Humans , Child , Erythema Infectiosum/etiology , Histoplasma/isolation & purification , Histoplasmosis/diagnosis , Atypical Bacterial Forms , Blotting, Western , Culture Media , Fever , Fever/etiology , Histoplasmosis/immunology , Histoplasmosis/therapy , Immunocompromised Host/immunology , Immunohistochemistry , Itraconazole/therapeutic use , Polysaccharides, Bacterial/analysisABSTRACT
Desde su descubrimiento hace menos de 25 años, mucho se ha progresado en el conocimiento de la infección causada por parvovirus B19, reconociéndose actualmente un amplio espectro de manifestaciones y la existencia de infecciones crónicas o persistentes. Este agente debe ser considerado en el diagnóstico diferencial de las variadas entidades clínicas que se describen en esta revisión. En este artículo se discuten también aspectos históricos, virológicos, epidemiológicos, de diagnóstico y manejo terapéutico de las infecciones por parvovirus B19
Subject(s)
Humans , Erythema Infectiosum/etiology , Parvoviridae Infections/etiology , Parvovirus B19, Human/pathogenicity , Anemia, Aplastic/etiology , Anemia, Aplastic/drug therapy , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Erythema Infectiosum/diagnosis , Erythema Infectiosum/drug therapy , Erythema Infectiosum/transmission , Immunocompromised Host , Hydrops Fetalis/drug therapy , Hydrops Fetalis/etiology , Immunoglobulins, Intravenous/therapeutic use , Parvoviridae Infections/diagnosis , Parvovirus B19, Human/drug effects , Parvovirus B19, Human/isolation & purificationSubject(s)
Humans , Enterovirus/pathogenicity , Exanthema/etiology , Herpesviridae/classification , Acyclovir/therapeutic use , Chickenpox Vaccine/therapeutic use , Chickenpox/drug therapy , Chickenpox/etiology , Erythema Infectiosum/etiology , Exanthema Subitum/etiology , Exanthema/classification , Herpesvirus 3, Human/pathogenicity , Herpesvirus 6, Human/pathogenicity , Parvovirus B19, Human/pathogenicityABSTRACT
No periodo de maio/94 a novembro/95, 24 casos de parvovirose humana foram atendidos no Servico de Doencas Infecciosas e Parasitarias do Hospital Universitario Antonio Pedro, Niteroi - RJ. Amostras sanguineas para a deteccao de IgM (ensaio imunoenzimatico por captura) foram positivas do primeiro ao vigesimo setimo dia apos o inicio do exantema. Os sinais e sintomas classicos do eritema infeccioso foram observados em 8 (33,3 por cento) dos casos e apenas em criancas. Oito pacientes (6 adultos e 2 criancas) apresentaram poliartropatia simetrica, vista mais frequentemente em mulheres. Os resultados deste trabalho demonstram que o diagnostico da parvovirose humana e dificil quando a doenca nao apresenta quadro clinico classico e, devido ao frequente envolvimento das articulacoes, tal infeccao deve ser considerada no diagnostico diferencial da artrite reumatoide na sua fase inicial