[CIS-PAGID] post transplant BK infection

[Richard Wasserman]

The patient is currently receiving cidofovir and has a cystotomy. She has
been transfused. I don't know about plasma BK PCR. Other than knowing more
virus is bad how does one interpret the difference between 1000, 10,000,
100,000 and 1,000,000 virons? Is there data that plasma viral load is more
prognostic than urinary load?
Richard

On Thu, Jun 23, 2011 at 11:41 AM, Cowan, Mort <mcowan at peds.ucsf.edu> wrote:


> Have they gotten a plasma BK PCR? If it’s positive people have used

> cidofovir with some success. If it’s just in the bladder then usually you

> just treat the hemorrhagic cystitis with hydration, looking to avoid clot

> formation in the bladder, until it resolves on its own. This can take

> several weeks. How severe is it? Are transfusions being required and at what

> frequency? I suppose you could consider cidofovir if it’s severe enough even

> if not systemic infection. The issue, of course, is the renal toxicity from

> cidofovir but probenecid protects the kidneys to some extent.****

>

> ** **

>

> Mort****

>

> ** **

>

> Morton J. Cowan, M.D.****

>

> Professor of Pediatrics****

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> Chief, Blood and Marrow Transplant Division****

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> UCSF Children's Hospital, Room M659****

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> 505 Parnassus Ave****

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> San Francisco, CA 94143-1278****

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> *From:* pagid-bounces at list.clinimmsoc.org [mailto:

> pagid-bounces at list.clinimmsoc.org] *On Behalf Of *Kirkpatrick, Charles

> *Sent:* Thursday, June 23, 2011 8:43 AM

>

> *To:* 'pagid at list.clinimmsoc.org'

> *Subject:* Re: [CIS-PAGID] post transplant BK infection****

>

> ** **

>

> Richard:****

>

> ** **

>

> I have a patient with CVID who was also on immunosuppression for her renal

> transplant.  Her BK virus infection cleared when the transplant team reduced

> her immunosuppressive treatment.  There were no adverse effects on kidney

> function.****

>

> ** **

>

> Chuck Kirkpatrick****

>

> ** **

>

> *From:* pagid-bounces at list.clinimmsoc.org [mailto:

> pagid-bounces at list.clinimmsoc.org] *On Behalf Of *Richard Wasserman

> *Sent:* Wednesday, June 22, 2011 3:09 PM

>

> *To:* PAGID

> *Subject:* [CIS-PAGID] post transplant BK infection****

>

> ** **

>

> My heme/onc colleagues have transplanted a two year old AML in remission

> who is now one month post-transplant and has reconstituted well. She would

> be home at this time but for severe hemorrhagic cystitis due to BK viral

> infection. Any suggestions?

> Thank you,

> Richard Wasserman

>

> --

> Richard L. Wasserman, MD, PhD

> DallasAllergyImmunology

> 7777 Forest Lane, Suite B-332

> Dallas, Texas 75230

> Office (972) 566-7788

> Fax (972) 566-8837

> Cell (214) 697-7211****

>




-- 
Richard L. Wasserman, MD, PhD
DallasAllergyImmunology
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788
Fax (972) 566-8837
Cell (214) 697-7211
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