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Pediatric Nephrology

, Volume 20, Issue 4, pp 529–533 | Cite as

Central nervous system vasculitis secondary to parvovirus B19 infection in a pediatric renal transplant patient

  • Ilmay Bilge
  • Banu SadıkoğluEmail author
  • Sevinç Emre
  • Aydan Şirin
  • Kubilay Aydın
  • Burak Tatlı
Brief Report

Abstract

Central nervous system (CNS) vasculitis secondary to chronic parvovirus B19 (B19) infection presenting with recurrent neurological findings is a very rare disorder during childhood. Here we report a 12-year-old boy with a renal transplant who had chronic B19 infection with skin eruptions and recurrent episodes of encephalopathy with focal neurological deficits. B19 DNA was detected in blood, bone marrow, and skin biopsy specimens. Repeat cranial magnetic resonance (MR) imaging during each episode of encephalopathy showed variable focal findings, and MR angiography revealed vasculitic changes with narrowing of the cerebral arteries. We hypothesized that the CNS vasculitis might be associated with the chronic B19 infection. At the time of his fourth presentation with the same clinical findings, we administered intravenous immunoglobulin (IVIG) (1 g/kg per day, 2 consecutive days), which we continued for 6 months, at monthly intervals. IVIG therapy resulted in remission and has been effective not only for the clearance of B19, but also for the improvement of clinical and radiological findings of CNS vasculitis. We suggest that chronic B19 infection should be considered in immunocompromised patients with suspected CNS vasculitis. IVIG should be considered as a part of the treatment.

Keywords

Central nervous system Intravenous immunoglobulin Immunosuppression Parvovirus B 19 Vasculitis 

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Copyright information

© IPNA 2005

Authors and Affiliations

  • Ilmay Bilge
    • 1
  • Banu Sadıkoğlu
    • 1
    • 4
    Email author
  • Sevinç Emre
    • 1
  • Aydan Şirin
    • 1
  • Kubilay Aydın
    • 2
  • Burak Tatlı
    • 3
  1. 1.Department of Pediatrics, Division of Pediatric Nephrology, Istanbul Medical FacultyIstanbul UniversityIstanbulTurkey
  2. 2.Department of Radiology, Istanbul Medical FacultyIstanbul UniversityIstanbulTurkey
  3. 3.Department of Pediatrics, Division of Pediatric Neurology, Istanbul Medical FacultyIstanbul UniversityIstanbulTurkey
  4. 4.Funda 01-05IstanbulTurkey

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