Distinct clinical features of transplanted children with Parvovirus B19 infection.
Humans
Parvovirus B19, Human
/ immunology
Child
Female
Male
Child, Preschool
Parvoviridae Infections
/ virology
Hematopoietic Stem Cell Transplantation
/ adverse effects
Antibodies, Viral
/ blood
Infant
Adolescent
Immunoglobulin M
/ blood
Immunoglobulin G
/ blood
Transplant Recipients
DNA, Viral
/ blood
Viral Load
Organ Transplantation
/ adverse effects
Children
Clinical features
Parvovirus B19
Transplantation
Journal
Virology journal
ISSN: 1743-422X
Titre abrégé: Virol J
Pays: England
ID NLM: 101231645
Informations de publication
Date de publication:
10 May 2024
10 May 2024
Historique:
received:
29
12
2023
accepted:
02
05
2024
medline:
11
5
2024
pubmed:
11
5
2024
entrez:
10
5
2024
Statut:
epublish
Résumé
The immature and suppressed immune response makes transplanted children a special susceptible group to Parvovirus B19 (PVB19). However, the clinical features of transplanted children with PVB19 infection haven't been comprehensively described. We searched the medical records of all the transplant recipients who attended the Children's Hospital of Fudan University from 1 Oct 2020 to 31 May 2023, and reviewed the medical literature for PVB19 infection cases among transplanted children. A total of 10 cases of PVB19 infection were identified in 201 transplanted children at our hospital, and the medical records of each of these cases were shown. Also, we retrieved 40 cases of PVB19 infection among transplanted children from the literature, thus summarizing a total of 50 unique cases of PVB19 infection. The median time to the first positive PVB19 DNA detection was 14 weeks post-transplantation. PVB19 IgM and IgG were detected in merely 26% and 24% of the children, respectively. The incidence of graft loss/dysfunction was as high as 36%. Hematopoietic stem cell transplant (HSCT) recipients showed higher PVB19 load, lower HGB level, greater platelet damage, lower PVB19 IgM/IgG positive rates, and more graft dysfunction than solid-organ transplant (SOT) recipients, indicating a more incompetent immune system. Compared with the published data of transplanted adults, transplanted children displayed distinct clinical features upon PVB19 infection, including lower PVB19 IgM/IgG positive rates, more graft dysfunction, and broader damage on hematopoietic cell lines, which was even more prominent in HSCT recipients, thus should be of greater concern.
Sections du résumé
BACKGROUND
BACKGROUND
The immature and suppressed immune response makes transplanted children a special susceptible group to Parvovirus B19 (PVB19). However, the clinical features of transplanted children with PVB19 infection haven't been comprehensively described.
METHODS
METHODS
We searched the medical records of all the transplant recipients who attended the Children's Hospital of Fudan University from 1 Oct 2020 to 31 May 2023, and reviewed the medical literature for PVB19 infection cases among transplanted children.
RESULTS
RESULTS
A total of 10 cases of PVB19 infection were identified in 201 transplanted children at our hospital, and the medical records of each of these cases were shown. Also, we retrieved 40 cases of PVB19 infection among transplanted children from the literature, thus summarizing a total of 50 unique cases of PVB19 infection. The median time to the first positive PVB19 DNA detection was 14 weeks post-transplantation. PVB19 IgM and IgG were detected in merely 26% and 24% of the children, respectively. The incidence of graft loss/dysfunction was as high as 36%. Hematopoietic stem cell transplant (HSCT) recipients showed higher PVB19 load, lower HGB level, greater platelet damage, lower PVB19 IgM/IgG positive rates, and more graft dysfunction than solid-organ transplant (SOT) recipients, indicating a more incompetent immune system.
CONCLUSIONS
CONCLUSIONS
Compared with the published data of transplanted adults, transplanted children displayed distinct clinical features upon PVB19 infection, including lower PVB19 IgM/IgG positive rates, more graft dysfunction, and broader damage on hematopoietic cell lines, which was even more prominent in HSCT recipients, thus should be of greater concern.
Identifiants
pubmed: 38730285
doi: 10.1186/s12985-024-02380-4
pii: 10.1186/s12985-024-02380-4
doi:
Substances chimiques
Antibodies, Viral
0
Immunoglobulin M
0
Immunoglobulin G
0
DNA, Viral
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
108Subventions
Organisme : the Key Development Program of Children's Hospital of Fudan University
ID : EK2022ZX05
Informations de copyright
© 2024. The Author(s).
Références
Sun P, Jiang P, Liu Q, Zhang R, Wang Z, Cao H, Ye X, Ji S, Han J, Lu K, et al. Parvovirus B19 DNA and antibodies in Chinese plasma donors, plasma pools and plasma derivatives. PeerJ. 2023;11:e15698.
doi: 10.7717/peerj.15698
pubmed: 37554334
pmcid: 10405795
Huang Q, Wang Y, Chen R, Zhao Y, Wang H, Ma X, Li D, Liu Q, Chen X, He L, et al. Parvovirus B19 infection in kidney transplant recipients: a prospective study in a teaching hospital in Shanghai, China. Transpl Immunol. 2022;74:101667.
doi: 10.1016/j.trim.2022.101667
pubmed: 35835294
Broliden K. Parvovirus B19 infection in pediatric solid-organ and bone marrow transplantation. Pediatr Transplant. 2001;5:320–30.
doi: 10.1034/j.1399-3046.2001.00035.x
pubmed: 11560750
Alves AD, Melgaço JG, Cássia Garcia Nc, JV Raposo Rd, de Paula VS, Araújo CC, Pinto MA, Amado LA. Persistence of Parvovirus B19 in liver from transplanted patients with acute liver failure. Future Microbiol. 2020;15:307–17.
doi: 10.2217/fmb-2019-0224
pubmed: 32286103
Eid AJ, Brown RA, Patel R, Razonable RR. Parvovirus B19 infection after transplantation: a review of 98 cases. Clin Infect Dis. 2006;43:40–8.
doi: 10.1086/504812
pubmed: 16758416
Holterhus M, Hennies M, Hillmann H, Thorer H, Rossig C, Burkhardt B, Groll AH. Parvovirus B19 infection in pediatric allogeneic hematopoietic cell transplantation - single-center experience and review. Transpl Infect Disease: Official J Transplantation Soc. 2023;25:e14028.
doi: 10.1111/tid.14028
Nour B, Green M, Michaels M, Reyes J, Tzakis A, Gartner JC, McLoughlin L, Starzl TE. Parvovirus B19 infection in pediatric transplant patients. Transplantation. 1993;56:835–8.
doi: 10.1097/00007890-199310000-00011
pubmed: 8212203
pmcid: 2978663
al-Khaldi N, Watson AR, Harris A, Irving WL. Dual infection with human herpesvirus type 6 and parvovirus B19 in a renal transplant recipient. Pediatr Nephrol. 1994;8:349–50.
doi: 10.1007/BF00866361
pubmed: 7917866
Assy N, Rosenthal E, Hazani A, Etzioni A, Baruch Y. Human parvovirus B19 infection associated with idiopathic thrombocytopenic purpura in a child following liver transplantation. J Hepatol. 1997;27:934–6.
doi: 10.1016/S0168-8278(97)80334-0
pubmed: 9382984
von Kaisenberg CS, Bender G, Scheewe J, Hirt SW, Lange M, Stieh J, Kramer HH, Jonat W. A case of fetal parvovirus B19 myocarditis, terminal cardiac heart failure, and perinatal heart transplantation. Fetal Diagn Ther. 2001;16:427–32.
doi: 10.1159/000053953
Moreux N, Ranchin B, Calvet A, Bellon G, Levrey-Hadden H. Chronic parvovirus B19 infection in a pediatric lung transplanted patient. Transplantation. 2002;73:565–8.
doi: 10.1097/00007890-200202270-00014
pubmed: 11889431
Yetgin S, Cetin M, Ozyürek E, Aslan D, Uçkan D. Parvovirus B19 infection associated with severe aplastic anemia in an immunocompetent patient. Pediatr Hematol Oncol. 2004;21:223–6.
doi: 10.1080/08880010490276935
pubmed: 15202161
Bilge I, Sadikoğlu B, Emre S, Sirin A, Aydin K, Tatli B. Central nervous system vasculitis secondary to parvovirus B19 infection in a pediatric renal transplant patient. Pediatr Nephrol. 2005;20:529–33.
doi: 10.1007/s00467-004-1736-1
pubmed: 15747163
Subtirelu MM, Flynn JT, Schechner RS, Pullman JM, Feuerstein D, Del Rio M. Acute renal failure in a pediatric kidney allograft recipient treated with intravenous immunoglobulin for parvovirus B19 induced pure red cell aplasia. Pediatr Transplant. 2005;9:801–4.
doi: 10.1111/j.1399-3046.2005.00379.x
pubmed: 16269055
Laurenz M, Winkelmann B, Roigas J, Zimmering M, Querfeld U, Müller D. Severe parvovirus B19 encephalitis after renal transplantation. Pediatr Transplant. 2006;10:978–81.
doi: 10.1111/j.1399-3046.2006.00599.x
pubmed: 17096771
So K, Macquillan G, Garas G, Delriviere L, Mitchell A, Speers D, Mews C, Augustson B, de Boer WB, Baker D, Jeffrey GP. Urgent liver transplantation for acute liver failure due to parvovirus B19 infection complicated by primary Epstein-Barr virus and cytomegalovirus infections and aplastic anaemia. Intern Med J. 2007;37:192–5.
doi: 10.1111/j.1445-5994.2006.01293.x
pubmed: 17316340
Pinto V, Grandy J, Zambrano P, Corta B, Salas P, Salgado I, Santander J, Salgado C, Chadid J, Iñiguez R. Severe anemia from parvovirus b19 infection in pediatric renal transplant recipients: two case reports. Transpl Proc. 2008;40:3261–4.
doi: 10.1016/j.transproceed.2008.03.127
Shen Q, Xu H, Cao Q, Zhou L-J, Xu J, Fang X-Y, Ge J. Long-term remission of recurrent severe anemia as a result of parvovirus B19 infection in a pediatric renal transplant recipient. Pediatr Transpl. 2011;15:E76–9.
doi: 10.1111/j.1399-3046.2010.01291.x
Bansal N, Drossner D. Chronic parvovirus infection in a pediatric cardiac transplant recipient: a case report. Clin Pediatr. 2013;52:681–3.
doi: 10.1177/0009922813490230
Bathla L, Grant WJ, Mercer DF, Vargas LM, Gebhart CL, Langnas AN. Parvovirus associated fulminant hepatic failure and aplastic anemia treated successfully with liver and bone marrow transplantation. A report of two cases. Am J Transplantation: Official J Am Soc Transplantation Am Soc Transpl Surg. 2014;14:2645–50.
doi: 10.1111/ajt.12857
Suzuki M, Ito Y, Shimada A, Saito M, Muramatsu H, Hama A, Takahashi Y, Kimura H, Kojima S. Long-term parvovirus B19 infections with genetic drift after cord blood transplantation complicated by persistent CD4 + lymphocytopenia. J Pediatr Hematol Oncol. 2014;36:e65–8.
doi: 10.1097/MPH.0000000000000008
pubmed: 24072236
Kelleher E, McMahon C, McMahon CJ. A case of parvovirus B19-induced pure red cell aplasia in a child following heart transplant. Cardiol Young. 2015;25:373–5.
doi: 10.1017/S1047951114000225
pubmed: 24555951
Zhang M, Zhong X, Zhang W, Xu J, Zhang M, Shen Y, Wang W, Zheng S. Human parvovirus B19 infection induced pure red cell aplasia in liver transplant recipients. Int J Clin Pract. 2015;69:29–34.
doi: 10.1111/ijcp.12664
Würdinger M, Modrow S, Plentz A. Impact of Parvovirus B19 Viremia in Liver transplanted children on Anemia: a retrospective study. Viruses. 2017;9:149.
doi: 10.3390/v9060149
pubmed: 28608818
pmcid: 5490825
Cruz RJ, Dasso JF, Duff C, Krasnopero D, Long Z, Ellison M, Nieves D, Sriaroon P, Asante-Korang A, Walter JE. Hyaluronidase-facilitated high-dose subcutaneous IgG effectively controls Parvovirus B19 infection in a Pediatric Cardiac Transplant patient with severe T-Cell Lymphopenia. Open Forum Infect Dis. 2020;7:ofaa076.
doi: 10.1093/ofid/ofaa076
pubmed: 32391400
pmcid: 7200086
Larkin T, Li P, Horn B. Parvovirus B19 infection masquerading as relapsed acute lymphoblastic leukaemia following haematopoietic stem cell transplantation. BMJ Case Rep. 2020;13:e235837.
doi: 10.1136/bcr-2020-235837
pubmed: 32816883
pmcid: 7437687
Zhang LY, Liu F, Chen X, Zhang XY, Ren YY, Zhang RR, Yang WY, Guo Y. [The hematological diversity of human parvovirus B19 infection after allo-hematopoietic stem cell transplantation in pediatric patients]. Zhonghua Xue Ye Xue Za Zhi = Zhonghua Xueyexue Zazhi. 2021;42:654–9.
pubmed: 34547871
Owens TJ, Patel SA, Greiner TC, Cannatella JJ, Grant WJ, Langnas AN, Vo HD. High-grade myelodysplastic syndrome in a pediatric multi-organ transplant recipient: a case report and literature review. Pediatr Transplant. 2022;26:e14287.
doi: 10.1111/petr.14287
pubmed: 35403329
Rattani N, Matheny C, Eckrich MJ, Madden LM, Quigg TC. Parvovirus B19-associated graft failure after allogeneic hematopoietic stem cell transplantation. Cancer Rep (Hoboken NJ). 2022;5:e1403.
doi: 10.1002/cnr2.1403
Broliden K. Parvovirus B19 infection in pediatric solid-organ and bone marrow transplantation. Pediatr Transpl. 2001;5:320–30.
doi: 10.1034/j.1399-3046.2001.00035.x
Gao L, Yang L, Zhou S, Zhu W, Han Y, Chen S, Xue S, Wang Y, Qiu H, Wu D, Wu X. Allogenic hematopoietic stem cell transplantation outcomes of patients aged ≥ 55 years with acute myeloid leukemia or myelodysplastic syndromes in China: a retrospective study. Stem Cell Res Ther. 2024;15:24.
doi: 10.1186/s13287-024-03640-4
pubmed: 38282037
pmcid: 10823660
Bieri J, Leisi R, Bircher C, Ros C. Human parvovirus B19 interacts with globoside under acidic conditions as an essential step in endocytic trafficking. PLoS Pathog. 2021;17:e1009434.
doi: 10.1371/journal.ppat.1009434
pubmed: 33878123
pmcid: 8087101
Shan YS, Lee PC, Wang JR, Tsai HP, Sung CM, Jin YT. Fibrosing cholestatic hepatitis possibly related to persistent parvovirus B19 infection in a renal transplant recipient. Nephrol Dialysis Transplantation: Official Publication Eur Dialysis Transpl Association - Eur Ren Association. 2001;16:2420–2.
doi: 10.1093/ndt/16.12.2420
Barzon L, Murer L, Pacenti M, Biasolo MA, Della Vella M, Benetti E, Zanon GF, Palù G. Investigation of intrarenal viral infections in kidney transplant recipients unveils an association between parvovirus B19 and chronic allograft injury. J Infect Dis. 2009;199:372–80.
doi: 10.1086/596053
pubmed: 19099488
Norja P, Hokynar K, Aaltonen LM, Chen R, Ranki A, Partio EK, Kiviluoto O, Davidkin I, Leivo T, Eis-Hübinger AM, et al. Bioportfolio: lifelong persistence of variant and prototypic erythrovirus DNA genomes in human tissue. Proc Natl Acad Sci U S A. 2006;103:7450–3.
doi: 10.1073/pnas.0602259103
pubmed: 16651522
pmcid: 1464359
Ning K, Zou W, Xu P, Cheng F, Zhang EY, Zhang-Chen A, Kleiboeker S, Qiu J. Identification of AXL as a co-receptor for human parvovirus B19 infection of human erythroid progenitors. Sci Adv. 2023;9:eade0869.
doi: 10.1126/sciadv.ade0869
pubmed: 36630517
pmcid: 9833669
Wang S, Qiu Z, Hou Y, Deng X, Xu W, Zheng T, Wu P, Xie S, Bian W, Zhang C, et al. AXL is a candidate receptor for SARS-CoV-2 that promotes infection of pulmonary and bronchial epithelial cells. Cell Res. 2021;31:126–40.
doi: 10.1038/s41422-020-00460-y
pubmed: 33420426