Departments/Institutions to which this work is attributable: Departments of Paediatric Nephrology, Infection and Paediatric Neurology, Guy's and St Thomas' NHS Foundation Trust, and the Virus Reference Department, Centre for Infections, Health Protection Agency.
Measles-Associated Encephalopathy in Children with Renal Transplants
Article first published online: 4 APR 2006
American Journal of Transplantation
Volume 6, Issue 6, pages 1459–1465, June 2006
How to Cite
Turner, A., Jeyaratnam, D., Haworth, F., Sinha, M. D., Hughes, E., Cohen, B., Jin, L., Kidd, I. M., Rigden, S. P. A. and MacMahon, E. (2006), Measles-Associated Encephalopathy in Children with Renal Transplants. American Journal of Transplantation, 6: 1459–1465. doi: 10.1111/j.1600-6143.2006.01330.x
- Issue published online: 4 APR 2006
- Article first published online: 4 APR 2006
- Received 13 August 2005, revised 27 January 2006 and accepted for publication 18 February 2006
- kidney transplantation;
Two children, boys of 8 and 13 years, presented with measles-associated encephalopathy several years after kidney transplantation for congenital nephrotic syndrome. In the absence of prior clinical measles, the neurological symptoms initially eluded diagnosis, but retrospective analysis of stored samples facilitated the diagnosis of measles-associated encephalopathy without recourse to biopsy of deep cerebral lesions. Each had received a single dose of measles mumps and rubella vaccine before 12 months of age. Prior vaccination, reduction of immunosuppression and treatment with intravenous immunoglobulin and ribavirin may have contributed to their survival. Persistent measles virus RNA shedding, present in one child, was not controlled by treatment with i.v. ribavirin. Two years later, both patients continue to have functioning allografts with only minimal immunosuppression. These cases illustrate the difficulty in diagnosing measles-associated encephalopathy in the immunocompromised host, even in the era of molecular diagnostics, and highlight the renewed threat of neurological disease in communities with incomplete herd immunity.