Cytomegalovirus infection is a trigger for monoclonal immunoglobulins in paediatric kidney transplant recipients

Ginevri, Fabrizio; Nocera, Arcangelo; Bonato, Luke; Losurdo, Giuseppe; Rossi, Giorgio; Mangraviti, Salvatore; Fontana, I.; Rabagliati, A. M.; Basile, Giancarlo; Barocci, S; Valente, Umberto; Gusmano, Rosanna

doi:10.1016/s0041-1345(98)00546-6

Cited by 10 publications

(8 citation statements)

References 15 publications

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“…The presence of cytomegalovirus after renal transplantation in pediatric patients is associated with an increased incidence of M‐proteins. Ginevri et al (207) reported that 57% of pediatric patients with cytomegalovirus infection had an M‐protein after renal transplantation, whereas only 8% of those without this infection had an M‐protein.…”

Section: Association Of Monoclonal Gammopathy With Other Diseasesmentioning

confidence: 99%

Monoclonal gammopathies of undetermined significance: a review

Kyle

Rajkumar

2003

Immunological Reviews

109

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Monoclonal gammopathy of undetermined significance (MGUS) denotes the presence of a monoclonal protein (M-protein) in patients without evidence of multiple myeloma (MM), macroglobulinemia, amyloidosis (AL), or a related plasma cell proliferative disorder. MGUS is found in approximately 3% of persons older than 70 years and in about 1% of those older than 50 years. In a series of 1384 patients from south-eastern Minnesota in whom MGUS was diagnosed at Mayo Clinic from 1960 through 1994, the risk of progression was 1% per year. Patients were at risk of progression even after 25 years or more of a stable monoclonal gammopathy. The risk of development of MM was increased by 25-fold, the risk of macroglobulinemia was 46-fold, and the risk of primary AL was 8.4-fold when compared with a similar population (Surveillance, Epidemiology and End Results). The concentration of the serum M-protein was the major independent predictor of progression. Patients with an immunoglobulin M (IgM) or an IgA monoclonal gammopathy had a higher risk of progression than those with an IgG monoclonal gammopathy. The presence of a urine M-protein or the reduction of one or more uninvolved Igs was not a risk factor for progression. MGUS may be associated with many different disorders, including lymphoproliferative diseases, leukemia, connective tissue disorders, dermatologic diseases, and neurologic disorders.

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Section: Association Of Monoclonal Gammopathy With Other Diseasesmentioning

confidence: 99%

Monoclonal gammopathies of undetermined significance: a review

Kyle

Rajkumar

2003

Immunological Reviews

109

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“…The association between CMV and MGUS (table 1) has been demonstrated previously in cohort studies with immunodeficient patients 9–17. Reports on this phenomenon in immunocompetent individuals are scarce and limited to three case reports and one small cohort study 18–21.…”

Section: Discussionmentioning

confidence: 52%

Cytomegalovirus infection with pulmonary embolism, splenic vein thrombosis and monoclonal gammopathy of undetermined significance: a case and systematic review

et al. 2019

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A 62-year-old immunocompetent woman was admitted with cytomegalovirus (CMV) infection, pulmonary embolism, splenic vein thrombosis and monoclonal gammopathy of undetermined significance (MGUS). Anticoagulation therapy was started. Two months later, seroconversion of CMV IgM to IgG was observed, while the monoclonal protein was no longer detectable. This suggests a relationship between acute CMV infection, transient MGUS and thrombosis. In accordance with current best practice guidelines for provoked venous thromboembolism (VTE), anticoagulation therapy could be discontinued after 3 months instead of 6 for unprovoked VTE, thereby reducing unnecessary time at risk of bleeding complications. While the relationships between CMV and both MGUS and thrombosis have been described independently, we are first to describe these three conditions occurring simultaneously.Furthermore, we provide a systematic review on the relation between CMV, MGUS and thrombosis.

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“…There are very little data available among the pediatric KT population . Despite the small number of enrolled patients, we found a 5% MGUS incidence among children after KT.…”

Section: Discussionmentioning

confidence: 55%

“…In 1998, Ginevri et al. demonstrated a 32% occurrence of MGUS in 80 pediatric patients after KT. We hypothesize that the higher incidence reported by Ginevri could be explained by the different etiology; MGUS were more frequent in CMV‐infected recipients, suggesting that CMV infection provides a more potent antigenic stimulus for alterations in immunoglobulin synthesis leading to the appearance of MGUS.…”

Section: Discussionmentioning

confidence: 99%

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Monoclonal gammopathy of undetermined significance in pediatric kidney transplant: A possible role of Epstein‐Barr virus

Giordano

Santangelo

Scarasciulli

et al. 2013

Pediatric Transplantation

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MG is a common event of hematologic malignancies. There are many papers regarding kidney transplantation patients with MGUS in adults, while data in pediatrics are scarce. The etiology and clinical significance of MGUS are unclear both in adults and children. Immunosuppressive drugs, graft antigenicity, and viral infection could play a possible role. The viruses most frequently implicated seem to be EBV or CMV in particular, but their role has to be defined better. However, many investigators have emphasized an impaired balance between an adequate immune response and reactivation of viral infection.

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Cytomegalovirus infection is a trigger for monoclonal immunoglobulins in paediatric kidney transplant recipients

Cited by 10 publications

References 15 publications

Monoclonal gammopathies of undetermined significance: a review

Monoclonal gammopathies of undetermined significance: a review

Cytomegalovirus infection with pulmonary embolism, splenic vein thrombosis and monoclonal gammopathy of undetermined significance: a case and systematic review

Monoclonal gammopathy of undetermined significance in pediatric kidney transplant: A possible role of Epstein‐Barr virus

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