title: Novel influenza (H1N1) infection in pediatric renal transplant recipients: a single center experience.
abstract: In 2009, novel influenza A H1N1 caused significant morbidity and mortality worldwide, particularly in children. Because they are immunocompromised, pediatric transplant recipients are presumed to be at high risk. This study assessed epidemiological characteristics, presenting symptoms, and clinical course among pediatric renal transplant recipients with confirmed H1N1 infection. A retrospective review was conducted in renal transplant recipients followed at The Hospital for Sick Children (Toronto) who contracted H1N1 infection between June and November, 2009. Epidemiological, clinical, and laboratory features at presentation, and clinical course were analyzed. Of 59 children, 14 (23.7%) developed H1N1 infection. Children with H1N1 infection had undergone kidney transplantation more recently than their uninfected counterparts. The most common symptoms included fever (92.9%), cough (85.7%), headache (42.9%), and vomiting (42.9%). Fifty percent of patients required hospitalization, of median duration 3.0 (1.0-5.0) days. No child required intensive care treatment. Half the H1N1-infected children had acute renal dysfunction, with serum creatinine elevated >10% above basal values (median increase 21.6 [14.3-46.2]%). In five of the seven children, serum creatinine returned to baseline within two wk. These findings indicate that H1N1 influenza infection in pediatric kidney transplant recipients followed at our center was surprisingly mild, and produced no lasting sequelae.
authors.affiliation: Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Frieling
authors.forename: Angela
authors.initials: A
authors.lastname: Williams
authors.forename: Turki
authors.initials: T
authors.lastname: Al Shareef
authors.forename: Gunjeet
authors.initials: G
authors.lastname: Kala
authors.forename: Jun Chuan
authors.initials: JC
authors.lastname: Teh
authors.forename: Valerie
authors.initials: V
authors.lastname: Langlois
authors.forename: Upton D
authors.initials: UD
authors.lastname: Allen
authors.forename: Diane
authors.initials: D
authors.lastname: Hebert
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Robinson
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D016030:Kidney Transplantation; D008297:Male; D009864:Ontario; D053139:Oseltamivir / Q000627:therapeutic use; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D053139:Oseltamivir