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Prevention of parvovirus B19-induced repetitive acute kidney failure by subcutaneous immunoglobulins.

Abstract

Human parvovirus B19 has been associated with various cases of kidney injuries with different glomerular phenotypes. In immunocompromised individuals, insufficient production of neutralizing antibodies can lead to chronic PVB19 carriage and manifestations. However, PVB19 DNA has been detected in bone marrow and peripheral blood for months or years in seemingly immunocompetent individuals, despite the presence of neutralizing antibodies. We report here PVB19-induced recurrent anuric acute kidney failures in a 57-year-old man over a 7-year period with persistent PVB19 infection and then PVB19-associated cryoglobulinemia. Acute renal failures were preceded by influenza-like syndrome associated with arthralgia, skin rash, and low-grade fever. Serum, bone marrow, renal, and digestive PVB19 replication was found in the different episodes. Endocapillary proliferative glomerulonephritis evolved into membranoproliferative glomerulonephritis. Complete renal recovery occurred after each bout. Off-label subcutaneous immunoglobulin therapy resulted in disappearance of blood and bone marrow PVB19 viral load and stopped the glomerulonephritis recurrence. Subcutaneous immunoglobulin therapy withdrawal resulted in renal relapse with cryoglobulin-associated manifestations.

Authors+Show Affiliations

Department of Nephrology and Clinical Immunology, University Hospital of Tours, Tours, France. Université de Tours, Tours, France.Université de Tours, Tours, France. Department of Virology, University hospital of Tours, Tours, France. INSERM U1259 and National Reference Center for HIV, Université de Tours, Tours, France.Department of Nephrology and Clinical Immunology, University Hospital of Tours, Tours, France. Université de Tours, Tours, France.Université de Tours, Tours, France. Department of Pathology, University Hospital of Tours, Tours, France.Department of Pathology, University Hospital of Tours, Tours, France.Department of Nephrology and Clinical Immunology, University Hospital of Tours, Tours, France.Université de Tours, Tours, France. Department of Virology, University hospital of Tours, Tours, France. INSERM U1259 and National Reference Center for HIV, Université de Tours, Tours, France.Department of Nephrology and Clinical Immunology, University Hospital of Tours, Tours, France. Université de Tours, Tours, France.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

31605404

Citation

Bailly, Elodie, et al. "Prevention of Parvovirus B19-induced Repetitive Acute Kidney Failure By Subcutaneous Immunoglobulins." Fundamental & Clinical Pharmacology, 2019.
Bailly E, Stefic K, Gatault P, et al. Prevention of parvovirus B19-induced repetitive acute kidney failure by subcutaneous immunoglobulins. Fundam Clin Pharmacol. 2019.
Bailly, E., Stefic, K., Gatault, P., Miquelestorena-Standley, E., Machet, M. C., Barbet, C., ... Halimi, J. M. (2019). Prevention of parvovirus B19-induced repetitive acute kidney failure by subcutaneous immunoglobulins. Fundamental & Clinical Pharmacology, doi:10.1111/fcp.12511.
Bailly E, et al. Prevention of Parvovirus B19-induced Repetitive Acute Kidney Failure By Subcutaneous Immunoglobulins. Fundam Clin Pharmacol. 2019 Oct 12; PubMed PMID: 31605404.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention of parvovirus B19-induced repetitive acute kidney failure by subcutaneous immunoglobulins. AU - Bailly,Elodie, AU - Stefic,Karl, AU - Gatault,Philippe, AU - Miquelestorena-Standley,Elodie, AU - Machet,Marie-Christine, AU - Barbet,Christelle, AU - Barin,Francis, AU - Halimi,Jean-Michel, Y1 - 2019/10/12/ PY - 2018/12/31/received PY - 2019/09/26/accepted PY - 2019/10/13/pubmed PY - 2019/10/13/medline PY - 2019/10/13/entrez KW - acute kidney injury KW - acute postinfectious glomerulonephritis KW - membranoproliferative glomerulonephritis KW - parvovirus B19 KW - subcutaneous immunoglobulins JF - Fundamental & clinical pharmacology JO - Fundam Clin Pharmacol N2 - Human parvovirus B19 has been associated with various cases of kidney injuries with different glomerular phenotypes. In immunocompromised individuals, insufficient production of neutralizing antibodies can lead to chronic PVB19 carriage and manifestations. However, PVB19 DNA has been detected in bone marrow and peripheral blood for months or years in seemingly immunocompetent individuals, despite the presence of neutralizing antibodies. We report here PVB19-induced recurrent anuric acute kidney failures in a 57-year-old man over a 7-year period with persistent PVB19 infection and then PVB19-associated cryoglobulinemia. Acute renal failures were preceded by influenza-like syndrome associated with arthralgia, skin rash, and low-grade fever. Serum, bone marrow, renal, and digestive PVB19 replication was found in the different episodes. Endocapillary proliferative glomerulonephritis evolved into membranoproliferative glomerulonephritis. Complete renal recovery occurred after each bout. Off-label subcutaneous immunoglobulin therapy resulted in disappearance of blood and bone marrow PVB19 viral load and stopped the glomerulonephritis recurrence. Subcutaneous immunoglobulin therapy withdrawal resulted in renal relapse with cryoglobulin-associated manifestations. SN - 1472-8206 UR - https://www.unboundmedicine.com/medline/citation/31605404/Prevention_of_parvovirus_B19-induced_repetitive_acute_kidney_failure_by_subcutaneous_immunoglobulins L2 - https://doi.org/10.1111/fcp.12511 DB - PRIME DP - Unbound Medicine ER -