1. Parvovirus B19 infection and kidney injury: report of 4 cases and analysis of immunization and viremia in an adult cohort of 100 patients undergoing a kidney biopsy.
- Author
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Kauffmann M, Bobot M, Daniel L, Torrents J, Knefati Y, Moranne O, Burtey S, Zandotti C, and Jourde-Chiche N
- Subjects
- Acute Kidney Injury blood, Acute Kidney Injury immunology, Acute Kidney Injury pathology, Adolescent, Adult, Aged, Aged, 80 and over, Biopsy, Erythema Infectiosum blood, Erythema Infectiosum complications, Female, Glomerulonephritis blood, Glomerulonephritis immunology, Glomerulonephritis pathology, Glomerulonephritis virology, Glomerulonephritis, Membranoproliferative blood, Glomerulonephritis, Membranoproliferative immunology, Glomerulonephritis, Membranoproliferative pathology, Glomerulonephritis, Membranoproliferative virology, Hemolytic-Uremic Syndrome blood, Hemolytic-Uremic Syndrome immunology, Hemolytic-Uremic Syndrome pathology, Hemolytic-Uremic Syndrome virology, Humans, Immunoglobulin G immunology, Immunoglobulin M immunology, Incidence, Kidney, Kidney Tubular Necrosis, Acute blood, Kidney Tubular Necrosis, Acute immunology, Kidney Tubular Necrosis, Acute pathology, Kidney Tubular Necrosis, Acute virology, Male, Middle Aged, Nephrosis, Lipoid blood, Nephrosis, Lipoid immunology, Nephrosis, Lipoid pathology, Nephrosis, Lipoid virology, Parvovirus B19, Human genetics, Seroepidemiologic Studies, Viremia blood, Young Adult, Acute Kidney Injury virology, Antibodies, Viral immunology, DNA, Viral blood, Erythema Infectiosum immunology, Parvovirus B19, Human immunology
- Abstract
Background: The seroprevalence of human Parvovirus B19 (PVB19) is 70-85% in adults worldwide. PVB19 is the etiologic agent of the fifth disease, is a cause of aplastic anemia, and can be associated with kidney injury. We aimed to describe the cases of 4 patients with kidney injury related to PVB19 primary infection, and to evaluate the seroprevalence of PVB19 and the incidence of PVB19 primary infection in patients undergoing a native kidney biopsy., Methods: Cases of PVB19 infection with kidney injury were reviewed from the archives of the department of Nephrology. A systematic screening of anti-PVB19 IgG and IgM antibodies and viral DNA was performed in sera from 100 consecutive patients with a kidney biopsy in 2017-2018., Results: The 4 patients with PVB19 infection-associated kidney disease displayed: one lupus-like glomerulonephritis (GN) without lupus auto-antibodies, one minimal change disease with tubular necrosis, one secondary hemolytic and uremic syndrome and one membrano-proliferative GN. In the 100 patients biopsied, 67 had elevated anti-PVB19 IgG, among whom 8 had elevated IgM, without circulating viral DNA, without any particular renal pathological pattern. One additional patient showed a seroconversion at the time of kidney biopsy, which revealed a class V lupus nephritis., Conclusion: PVB19 primary infection can be associated with different kidney diseases. The seroprevalence of PVB19 among patients with a kidney biopsy is similar to the overall population, and primary infection is rarely documented (1%) after systematic screening. Whether PV19 is nephrotoxic, or triggers renal endothelial injury and immune activation, remains to be elucidated.
- Published
- 2020
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