Pure red cell aplasia due to parvovirus B19 infection in solid organ transplantation.
Human parvovirus B19 disease is an infrequent but recognized rare cause of anemia in immunocompromised patients. A few cases of parvovirus B19 infections have been reported in transplant recipients, of those only four patients underwent renal transplantation. The primary immunosuppressive therapy in these patients included prednisone with either cyclosporine or tacrolimus. In one patient the disease was self-limiting, while in three others the hematocrit improved following 10-15 d of treatment with commercial intravenous immunoglobulin (IVIG). Herein, we report the fifth case of pure red cell aplasia due to parvovirus B19 infection in a renal transplant recipient who responded to a 5-d course of IVIG. To our knowledge, this is the first case of parvovirus B19 infection in a patient with solid-organ transplantation whose immunosuppressive regimen included both mycophenolate mofetil and tacrolimus and in whom an excellent clinical response was achieved with a short course of IVIG infusion.
Ahsan
N
N
Department of Medicine, Milton S. Hershey Medical Center, Pennsylvania State University, College of Medicine, Hershey 17033, USA.
Holman
M J
MJ
Gocke
C D
CD
Groff
J A
JA
Yang
H C
HC
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002102:Cadaver; D016572:Cyclosporine / Q000627:therapeutic use; D004279:DNA, Viral / Q000032:analysis / Q000235:genetics; D006400:Hematocrit; D006801:Humans; D015151:Immunoblotting; D016867:Immunocompromised Host; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007262:Infusions, Intravenous; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010322:Parvoviridae Infections; D016732:Parvovirus B19, Human / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D011241:Prednisone / Q000627:therapeutic use; D012010:Red-Cell Aplasia, Pure / Q000097:blood / Q000628:therapy / Q000821:virology*; D012074:Remission Induction; D016559:Tacrolimus / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D004279:DNA, Viral; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009173:Mycophenolic Acid; D011241:Prednisone; D016559:Tacrolimus