患有帕尔沃病毒B19感染的移植儿童的独特临床特征
Ran Jia1, Lingfeng Cao1, Lijuan Lu1
1Department of Clinical Laboratory, Children's Hospital of Fudan University & National Children's Medical Center, Shanghai, 201102, China.
Virology journal
|May 10, 2024
概括
移植儿童极易感染帕尔沃病毒B19 (PVB19),导致显著的移植功能障碍. 血造干细胞移植受体面临更大的风险,突出了儿科病例中明显的临床特征.
科学领域:
- 儿童传染病 儿童传染病
- 移植免疫学 移植免疫学
- 病毒学 病毒学
背景情况:
- 移植儿童具有不成熟和抑制的免疫系统,使他们特别容易受到帕尔沃病毒B19 (PVB19) 感染.
- 在儿科移植接受者中PVB19感染的临床表现需要全面描述.
研究的目的:
- 在儿科移植接受者中全面描述帕尔沃病毒B19感染的临床特征.
- 为了比较血造干细胞移植 (HSCT) 和固体器官移植 (SOT) 接受者之间的临床特征.
主要方法:
- 复旦大学儿童医院 (2010年10月至2023年5月) 201名移植患者的医疗记录的回顾性审查.
- 在文献中搜索移植儿童中PVB19感染的额外病例.
- 对临床数据,病毒载量,免疫标记物 (IgM/IgG) 和移植结果的分析.
主要成果:
- 在移植儿童中发现了50例PVB19感染病例 (10例来自机构,40例来自文献).
- 移植后PVB19DNA检测的中位时间为14周;PVB19IgM/IgG阳性率较低 (26%和24%).
- 移植损失/功能障碍发生在36%的病例中;与SOT接受者相比,HSCT接受者表现出更高的病毒载量,更低的血红蛋白,更大的血小板损伤,更低的抗体率和更多的移植功能障碍.
结论:
- 与成人相比,移植儿童具有PVB19感染的明显临床特征,包括较低的抗体检测率和更显著的移植功能障碍.
- 对造血细胞系的影响在儿童中更为广泛,特别是在HSCT接受者中,这需要增加临床关注.
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