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Intravenous immunoglobulin as rescue therapy for BK virus nephropathy
Author(s) -
Sharma Ajay P.,
Moussa Madeleine,
Casier Shelley,
Rehman Faisal,
Filler Guido,
Grimmer Joanne
Publication year - 2009
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2008.00958.x
Subject(s) - medicine , cidofovir , immunosuppression , concomitant , bk virus , nephropathy , viremia , immunology , antibody , kidney , kidney transplantation , virus , endocrinology , diabetes mellitus
BKVN has emerged as an important cause of pediatric renal allograft nephropathy, with significant graft dysfunction in majority of the cases. Reduced immunosuppression and cidofovir therapy are the most commonly used therapeutic options for the treatment of BKVN in these patients. Recently, a preliminary study in adult renal allograft recipients with BKVN showed a therapeutic response to a combined approach of immunosuppression reduction and IVIg administration. A therapeutic benefit of IVIg without another concomitant treatment intervention has not been evaluated. We report stabilization of renal functions, histological resolution of BKVN and significant reduction in BK viremia in pediatric renal transplant with the use of IVIg, after an inadequate response to immunosuppression reduction and cidofovir therapy. In addition, we review the current literature on the use of cidofovir in pediatric renal transplant patients with BKVN and the potential of IVIg use in this condition.