title: How many times can parvovirus B19-related anemia recur in solid organ transplant recipients?
abstract: Parvovirus B19 (PB19) infection is known to cause acute erythroblastopenia-mediated anemia in solid organ transplant (SOT) recipients. Intravenous immunoglobulins (IVIg) and the decrease of immunosuppression level are supposed to induce a long-term remission, although no consensus exists about the dose and the schedule of IVIg administrations. However, a few reports have shown that PB19-related anemia can recur despite this treatment, with a maximum of 3 recurrences reported. In this report, we describe in detail the cases of 2 kidney recipients with PB19 infection. They experienced, respectively, 9 and 7 PB19-related anemia recurrences. Immunosuppression level was decreased and IVIg were administered at each recurrence followed by a transitory normalization of hemoglobin level and a decrease of serum PB19 viral load. Episodes were separated by several months. These patients raise an original therapeutic management question about a frequent viral infection in SOT recipients. One patient is currently receiving IVIg every 3 months as a secondary prophylaxis without recurrence to date. These 2 case reports are followed by a review of the literature.
authors.affiliation: Néphrologie-Transplantation, Hôpital Saint-Louis, Université Paris VII, Paris, France. gossetclement@yahoo.fr
authors.forename: C
authors.initials: C
authors.lastname: Gosset
authors.forename: D
authors.initials: D
authors.lastname: Viglietti
authors.forename: K
authors.initials: K
authors.lastname: Hue
authors.forename: C
authors.initials: C
authors.lastname: Antoine
authors.forename: D
authors.initials: D
authors.lastname: Glotz
authors.forename: E
authors.initials: E
authors.lastname: Pillebout
mesh_terms: D000328:Adult; D000740:Anemia / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D010322:Parvoviridae Infections / Q000150:complications* / Q000821:virology*; D016732:Parvovirus B19, Human / Q000302:isolation & purification*; D012008:Recurrence
chemical_list: D016756:Immunoglobulins, Intravenous