Clinical course and treatment of haemorrhagic cystitis associated with BK type of human polyomavirus in nine paediatric recipients of allogeneic bone marrow transplants
| Autor: | Ortwin Adams, K. Dörries, Thomas A. Vögeli, E.-M. de Villiers, S Burdach, Frank Peinemann |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Male
Pathology medicine.medical_specialty Adolescent Hemorrhagic Disorders medicine.disease_cause Gastroenterology Virus Serology Excretion Internal medicine Cystitis Humans Medicine Child Busulfan Bone Marrow Transplantation Preparative Regimen Polyomavirus Infections business.industry BK virus Tumor Virus Infections medicine.anatomical_structure BK Virus Child Preschool Pediatrics Perinatology and Child Health Female Virus Activation Bone marrow Tamponade business Immunosuppressive Agents medicine.drug |
| Zdroj: | European Journal of Pediatrics. 159:182-188 |
| ISSN: | 1432-1076 0340-6199 |
| DOI: | 10.1007/s004310050047 |
| Popis: | Of a total of 117 bone marrow transplant (BMT) recipients in the period from August 1988 to November 1995, 9 (7.7%) developed haemorrhagic cystitis. This condition was characterized in all nine patients by late onset (day +24 to +50 post-BMT), long duration (1 to 7 weeks), and the excretion of BK virus in the urine, as confirmed by electron microscopy, DNA hybridization and PCR analysis. Adenovirus was not involved. The serological assessment of BK virus-specific IgM and IgG pre- and post-BMT is consistent with viral reactivation in all patients, although a primary infection cannot be absolutely excluded in a single patient. A significant correlation between the use of high-dose busulphan (16 mg/kg) in the preparative regimen and development of haemorrhagic cystitis (P = 0. 0003) was evident. The severe course of the disease in two patients resulted in bladder tamponade; bleeding could not be inhibited with coagulation and laser treatment. Deterioration was prevented by bladder irrigation via a suprapubic catheter. Remission occurred spontaneously in all patients.BK virus induced haemorrhagic cystitis in a paediatric bone marrow transplantation recipients is characterized by late onset, long duration, viral reactivation and correlates to high-dose busulphan. Severe bleeding could not be influenced by surgical intervention. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|