Respiratory syncytial virus infections in pediatric renal transplant recipients.
Respiratory syncytial virus infections in pediatric renal transplant recipients.
复制标题
儿童肾移植受者的呼吸道合胞病毒感染。
DOI：
10.1007/bf00862085
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发表时间：
1996
期刊：
影响因子：
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通讯作者：
Chavers,BM
中科院分区：
文献类型：
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作者：
Miller,RB;Chavers,BM
免疫功能低下的患者被认为呼吸道合胞病毒（RSV）感染的风险增加。我们研究了接受长期免疫抑制治疗的儿童肾移植（Tx）受者中RSV感染的发生率和结局。在1985年11月至1993年4月间移植的173名受体中，5名（3%）发生RSV感染（年龄范围11-39个月）。初始免疫抑制包括泼尼松、硫唑嘌呤、环孢菌素和多克隆抗体治疗。从Tx至RSV感染发作的时间为1天至7个月。症状包括流涕、咳嗽、呼吸急促、退缩、发热、喘息和胸部X光检查异常。治疗包括支气管扩张剂治疗、支气管引流、利巴韦林和雾化帐篷。2例受试者在治疗期间因白细胞减少暂时停用硫唑嘌呤。3例受者在RSV感染期间（n=2）或感染后立即（n=1）发生活检证实的急性排斥反应;所有受者均对皮质类固醇治疗有反应。RSV感染在儿科肾脏Tx接受者中不常见。我们的患者RSV感染的过程与正常儿童报告的没有差异。RSV和急性排斥反应之间的可能联系需要进一步观察。当早期诊断时，RSV感染似乎与儿科肾Tx接受者的死亡率增加无关。需要对更多的接受者进行研究以证实这些结果。
Immunocompromised patients are considered at increased risk from respiratory syncytial virus (RSV) infection. We examined the incidence and outcome of RSV infection in pediatric renal transplant (Tx) recipients on chronic immunosuppressive therapy. Of 173 recipients transplanted between November 1985 and April 1993, 5 (3%) developed RSV infection (age range 11–39 months). Initial immunosuppression included prednisone, azathioprine, cyclosporine, and polyclonal antibody therapy. Time from Tx to onset of RSV infection was 1 day to 7 months. Symptoms included rhinorrhea, cough, tachypnea, retractions, fever, wheezing, and abnormal chest X-ray. Treatment included bronchodilator therapy, bronchial drainage, ribavirin, and mist tent. Azathioprine was transiently withheld for leukopenia during treatment in 2 recipients. Three recipients developed biopsy-proven acute rejection during (n=2) or immediately following (n=1) RSV infection; all responded to corticosteroid treatment. RSV infection is not commonly diagnosed in pediatric renal Tx recipients. The course of RSV infection in our patients did not differ from that reported in normal children. The possible association between RSV and acute rejection warrants further observation. When diagnosed early, RSV infection does not appear to be associated with increased mortality in pediatric renal Tx recipients. Larger numbers of recipients need to be studied to confirm these results.