Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literature.

Autor: Yaghoubi F; Nephrology Research Center, Shariati Hospital Tehran University of Medical Sciences Tehran Iran., Dalil D; Student Research Committee, Faculty of Medicine Shahed University Tehran Iran., Tavakoli F; Nephrology Research Center, Shariati Hospital Tehran University of Medical Sciences Tehran Iran., Hosseini SM; Student Research Committee, Faculty of Medicine Shahed University Tehran Iran.
Jazyk: angličtina
Zdroj: Clinical case reports [Clin Case Rep] 2023 Sep 07; Vol. 11 (9), pp. e7906. Date of Electronic Publication: 2023 Sep 07 (Print Publication: 2023).
DOI: 10.1002/ccr3.7906
Abstrakt: Key Clinical Message: PB19 infection should be considered an uncommon cause of posttransplant anemia in renal transplant recipients, particularly those whose anemia is not associated with common etiologies. IVIG treatment and reduced immunosuppression could be beneficial.
Abstract: Parvovirus B19-associated relapsing anemia is rare in kidney transplant recipients. Herein, we report a case of relapsed anemia due to parvovirus B19 infection in a 53-year-old woman 18 months after kidney transplantation. The patient presented with palpitations, shortness of breath, dizziness, weakness, and lethargy. Early laboratory findings showed a WBC count of 6.000/μL, RBC count of 1.89/μL, hemoglobin (Hb) 3.5 g/dL, hematocrit (Hct) 15%, platelet count 266.000/μL, MCV 89, reticulocyte count 0.8%, and serum iron 221 μg/dL. Upon further evaluation, the RT-PCR test for BK polyomavirus and cytomegalovirus (CMV) was negative, while the parvovirus B19 RT-PCR was positive. The patient was treated with blood transfusion and IVIG 25 g daily for 5 days. Two months after discharge, the patient presented, complaining of palpitation, shortness of breath, and dizziness, with RBC 2.7/μL, Hb 6.5 g/dL, Hct 25%, and MCV 85. Again, the CMV RT-PCR was negative, while the parvovirus B19 RT-PCR was positive. Tacrolimus and mycophenolic acid were stopped, and IVIG 25 g daily for 5 days was administered. Consequently, her Hb level increased to 9 g/dL, and the patient was discharged with prednisolone 5 mg daily and cyclosporine 50 mg daily instead of tacrolimus. Viral infection, particularly PB19 infection, should be considered in the differential diagnosis of posttransplantation anemia in KTRs. IVIG treatment and modification of immunosuppressive medications are suggested standard therapies for such patients. The function of transplanted kidneys should be carefully monitored during treatment.
Competing Interests: The authors declare that they have no conflicts of interest.
(© 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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