title: Parvovirus B19 microepidemic in renal transplant recipients with thrombotic microangiopathy and allograft vasculitis.
abstract: Parvovirus B-19 (B-19) can lead to various clinical scenarios in renal transplant recipients. Here, we report a B-19 microepidemic that occurred between January and March 2007, involving renal transplant recipients from a single center in Tabriz, Iran. We observed 6 patients in whom there was a temporal association between active B-19 infection and thrombotic microangiopathy and intrarenal small and medium-sized vessel vasculitis. Patients typically presented with deteriorating renal allograft function and anemia, and laboratory findings revealed thrombotic microangiopathy. Ultimately, extensive endothelial injury and renal allograft vasculitis that mimicked a vascular rejection ensued. In conclusion, B-19-related thrombotic microangiopathy may precede allograft vasculitis in renal transplant recipients. A high index of suspicion is required for early diagnosis and treatment of B-19 infection. To the best of our knowledge, this series represents the first report of B-19-related renal allograft vasculitis in the English literature.
authors.affiliation: Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Ardalan
authors.forename: Mohammadali M
authors.initials: MM
authors.lastname: Shoja
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: David
authors.initials: D
authors.lastname: Jayne
mesh_terms: D000328:Adult; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007492:Iran; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010322:Parvoviridae Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D016732:Parvovirus B19, Human; D011183:Postoperative Complications; D013927:Thrombosis / Q000175:diagnosis / Q000821:virology*; D014657:Vasculitis / Q000175:diagnosis / Q000821:virology*