[INTRAVENOUS IMMUNOGLOBULIN TREATMENT TO PREVENT BK NEPHROPATHY IN PEDIATRIC RENAL TRANSPLANT RECIPIENTS WITH BK VIRUS].
Harefuah
; 160(12): 801-805, 2021 Dec.
Article
en He
| MEDLINE
| ID: mdl-34957715
ABSTRACT
AIMS:
In this retrospective study we examined the safety and efficacy of high-dose intravenous immunoglobulin (HD-IVIG) therapy in preventing BKVN in pediatric renal transplant recipients with BK-viremia/viruria.BACKGROUND:
BK virus nephropathy (BKVN) is diagnosed in 5-16% of pediatric renal transplant recipients and is preceded by BK viremia/viruria. Despite irreversible renal damage associated with BKVN, there is a lack of evidence-based guidelines for preventive measures in patients with BK viremia/viruria.METHODS:
All pediatric renal transplant recipients under our care underwent routine testing for urine and blood BK virus, using the polymerase chain reaction (PCR) technique. Patients exhibiting BK-viruria < 107 copies/milliliter (ml) and/or BK-viremia<103 copies/ml without any evidence of BKVN, were managed with 50% dose reduction of the immunosuppressive drug mycophenolate mofetil (MMF). Absence of BK viral load decline within two months from MMF dose reduction was managed with HD-IVIG (at 2 grams/kg body weight).RESULTS:
The study included 62 patients over a 6-year period; 31 patients (50%) showed BK-viremia/viruria; 13/31 patients (42%) suffered from significant and persistent BK-viremia/viruria, unresponsive to MMF dose reduction, and were managed with HD-IVIG; 12/13 (92%) showed significant BK viral load reduction within 6 months from HD-IVIG therapy. Except for transient headache, no patient exhibited major adverse effects to HD-IVIG therapy, and none developed overt BKVN during the study period.CONCLUSIONS:
Preventive HD-IVIG therapy in pediatric renal transplant recipients with BK viremia/viruria unresponsive to MMF dose reduction is safe and effective in preventing the development of BKVN. Additional large-scale studies are necessary to establish our findings.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Infecciones Tumorales por Virus
/
Trasplante de Riñón
/
Inmunoglobulinas Intravenosas
/
Infecciones por Polyomavirus
Tipo de estudio:
Guideline
/
Observational_studies
Límite:
Child
/
Humans
Idioma:
He
Revista:
Harefuah
Año:
2021
Tipo del documento:
Article
País de afiliación:
Israel