Measles in pediatric liver transplant recipients: A report of 4 cases
10.3760/cma.j.issn.0254-1785.2015.01.005
- VernacularTitle:婴幼儿肝移植术后麻疹病毒感染四例报告
- Author:
Ying LIU
;
Liying SUN
;
Zhijun ZHU
;
Lin WEI
;
Wei QU
;
Zhigui ZENG
- Publication Type:Journal Article
- Keywords:
Pediatric;
Liver transplantation;
Measles
- From:
Chinese Journal of Organ Transplantation
2015;36(1):20-23
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize and explore the clinical characteristics,treatment and outcome of measles in pediatric liver transplant recipients.Method A total of 56 recipients underwent pediatric liver transplantation from June 2013 to April 2014,and 4 recipients suffered from measles post-liver transplantation with the incidence being 7.1％.The data of 4 recipients were retrospectively analyzed.All of the 4 cases were subjected to liver transplantation at our center for biliary atresia and cholestasis liver cirrhosis.All the patients received the combined immunosuppressive regimen on the basis of tacrolimus.All the patients did not accept the immunization with measles vaccine because of the primary liver diseases.All the cases presented the clinical manifestations of cough,high fever (T ＞38.5℃C) and conjunctiva congestion before the rashes came out.Maculopapular rashes appeared about 4 days after the fever.The rashes first appeared from the skine post aurem,face,neck,and then spread to trunk and extremities.Koplik's spots on the buccal mucosa were observed in all the 4 cases.The serological test of IgM antibodies to measles was done.The treatment was adjusted as soon as the diagnosis of measles was clear.Immunosuppressants were decreased or stopped,intravenous immunoglobulin (IVIG) combined with anti-infection drugs was given.Result The clinical manifestation of measles in pediatric liver transplant recipients was serious.There were 3 cases complicated with pneumonia,and one case with laryngitis.Two cases presented severe measles pneumonia and developed into severe respiratory failure requiring mechanical ventilation.Three eases recovered from the therapy and 1 case died of respiratory failure.Conclusion Pediatric liver transplant recipients who suffered from measles are at high risk of severe pneumonia.Measles pneumonitis is frequently fatal in immunocompromised pediatric patients.The treatment shoule be given as soon as possible.
