02627nas a2200313   4500008004100000020001400041024001700055245015600072210006900228260030500297300001400602490000600616520137000622653001101992653001302003653002502016653003102041653001102072653002602083653001802109653001502127100002202142700001802164700002302182700001902205700002302224700002102247856004502268       2005                        eng d  a1397-3142  ac8x, 980257400aAcute renal failure in a pediatric kidney allograft recipient treated with intravenous immunoglobulin for parvovirus B19 induced pure red cell aplasia.0 aAcute renal failure in a pediatric kidney allograft recipient tr  aCopyright (C) 2005 Blackwell Publishing Ltd.b(1)Department of Pediatrics, Division of Pediatric Nephrology, Children's Hospital at Montefiore, Bronx, NY, USA(2)Department of Surgery, Montefiore Medical Center, Bronx, NY, USA(3)Department of Pathology, Montefiore Medical Center, Bronx, NY, USAc2005  a801 - 8040 v93 aInfection with parvovirus B19 (PV-B19) after solid organ transplantation may cause pure red cell aplasia (PRCA). Intravenous immunoglobulin (IVIg) may be of benefit in clearing the infection. Acute renal failure is a known adverse effect of IVIg administration. A 14-yr-old male received a cadaveric renal transplant. Three weeks after surgery he developed symptomatic anemia (hemoglobin 4.5 g/dL, reticulocyte count 0.2%). Anti-PV-B19 IgM and IgG titers, which had been negative pretransplant, were positive. He received two IVIg infusions as treatment for the PV-B19 infection. Four days after the IVIg infusions he developed non-oliguric acute renal failure (ARF) with a rise in serum creatinine from 1 to 1.8 mg/dL. Allograft biopsy showed changes consistent with an osmotic load. Anemia and the renal failure resolved after transfusions and IVIg. PV-B19 infection in immunosuppressed transplant recipients is associated with significant morbidity and may respond to IVIg therapy. High sucrose IVIg preparations may be associated with renal failure in renal allograft recipients. Adding PV-B19 testing of the donor and recipient to the standard pretransplant evaluation may be beneficial in diagnosing and managing a potential infection. If IVIg is to be used it may be safer to use a sucrose-free IVIg preparation., Copyright (C) 2005 Blackwell Publishing Ltd.10aAnemia10achildren10ahuman parvovirus B1910aintravenous immunoglobulin10aKidney10apure red cell aplasia10arenal failure10atransplant1 aSubtirelu, Mihail1 aFlynn, Joseph1 aSchechner, Richard1 aPullman, James1 aFeuerstein, Dianne1 aDel Rio, Marcela  uhttp://613633.bywedr.asia/reference/4208