PDF(Pubmed)
Abstract：
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.
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.
摘要：
背景：未成熟和受抑制的免疫反应使移植儿童成为细小病毒B19（PVB19）的特殊易感人群。然而,移植患儿PVB19感染的临床特征尚未全面描述。
方法：我们检索了2020年10月1日至2023年5月31日在复旦大学附属儿童医院就诊的所有移植受者的病历，并回顾了移植患儿中PVB19感染病例的医学文献。
结果：我院201例移植患儿共发现10例PVB19感染，并显示了这些病例的医疗记录。此外，我们从文献中检索到40例移植儿童PVB19感染病例，因此总结了总共50例PVB19感染的独特病例。首次阳性PVB19DNA检测的中位时间为移植后14周。PVB19IgM和IgG仅在26％和24％的儿童中检测到，分别。移植物丢失/功能障碍的发生率高达36％。造血干细胞移植（HSCT）受者显示更高的PVB19负荷，较低的HGB水平，更大的血小板损伤，较低的PVB19IgM/IgG阳性率，与实体器官移植（SOT）接受者相比，移植物功能障碍更多，表明免疫系统更加无能。
结论：与已发表的成体移植数据相比，移植患儿在PVB19感染后表现出明显的临床特征，包括较低的PVB19IgM/IgG阳性率，更多的移植物功能障碍，以及对造血细胞系的更广泛的损害，这在HSCT接受者中更为突出，因此应该引起更大的关注。
方法：我们检索了2020年10月1日至2023年5月31日在复旦大学附属儿童医院就诊的所有移植受者的病历，并回顾了移植患儿中PVB19感染病例的医学文献。
结果：我院201例移植患儿共发现10例PVB19感染，并显示了这些病例的医疗记录。此外，我们从文献中检索到40例移植儿童PVB19感染病例，因此总结了总共50例PVB19感染的独特病例。首次阳性PVB19DNA检测的中位时间为移植后14周。PVB19IgM和IgG仅在26％和24％的儿童中检测到，分别。移植物丢失/功能障碍的发生率高达36％。造血干细胞移植（HSCT）受者显示更高的PVB19负荷，较低的HGB水平，更大的血小板损伤，较低的PVB19IgM/IgG阳性率，与实体器官移植（SOT）接受者相比，移植物功能障碍更多，表明免疫系统更加无能。
结论：与已发表的成体移植数据相比，移植患儿在PVB19感染后表现出明显的临床特征，包括较低的PVB19IgM/IgG阳性率，更多的移植物功能障碍，以及对造血细胞系的更广泛的损害，这在HSCT接受者中更为突出，因此应该引起更大的关注。
