Persistent anemia in a renal transplant recipient
| Autor: | Obi Okoye, David Mushatt, Janet Schmid |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Microbiology (medical)
Male medicine.medical_specialty Pathology Anemia viruses H&E stain Hematocrit Parvoviridae Infections Biopsy medicine Humans Aged medicine.diagnostic_test biology business.industry Parvovirus virus diseases Immunoglobulins Intravenous medicine.disease biology.organism_classification Kidney Transplantation Surgery Transplantation medicine.anatomical_structure Infectious Diseases Erythema Infectiosum Bone marrow business |
| Zdroj: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 40(8) |
| ISSN: | 1537-6591 |
| Popis: | Diagnosis: Chronic persistent parvovirus B19 infection. The bone marrow biopsy demonstrated markedly hypocellular marrow (10% cellularity) (figure 1) with incomplete erythroid maturation and increased storage of iron. Hematoxylin and eosin staining of the bone marrow specimen revealed occasional enlarged cells with prominent nuclear inclusions (giant pronormoblasts), which are characteristic of parvovirus B19 infection (figure 2). In contrast, cells infected with cytomegalovirus (CMV) usually have both cytoplasmic and intranuclear inclusions, which give the cells the characteristic "owl eye" appearance. The results of PCR of the bone marrow specimen for Epstein-Barr virus and CMV DNA were negative, and the findings of chromosomal analysis of bone marrow were also normal. The result of PCR of the bone marrow specimen for parvovirus B19 DNA was positive. The patient was treated with a 5-day regimen of intravenous immunoglobulin and has not required blood transfusions since the completion of treatment. His hematocrit rose quickly to 36%-37.9 % by 2 weeks after treatment and to 42.2% by 1 month after treatment. Parvovirus B19 is a nonenveloped, single-stranded DNA virus that commonly causes a benign childhood infection, fifth disease (erythema infectiosum), which typically manifests as a Figure 2. High-pow r micrograph (hematoxylin and eosin stain; original magnification, x100) of a bone marrow sp cimen showing giant pronormoblast (arrow) with prominent nuclear inclusions. |
| Databáze: | OpenAIRE |
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