title: Intravenous immunoglobulin therapy for pure red cell aplasia related to human parvovirus b19 infection: a retrospective study of 10 patients and review of the literature.
abstract: BACKGROUND
  We evaluated the efficacy of intravenous immunoglobulin (IVIG) therapy in patients with pure red cell aplasia (PRCA) related to human parvovirus B19 (HPV-B19) infection.
  
  
  METHODS
  We retrospectively reviewed all HPV-B19 PRCA cases treated with IVIG between January 2000 and December 2005 in the Assistance Publique-Hôpitaux de Paris hospitals and reviewed all cases of HPV-B19 PRCA cases treated with IVIG in the literature.
  
  
  RESULTS
  Among our 36 patients, PRCA was confirmed in 22, including 10 with proven HPV-B19 infection. Nine patients were immunocompromised, including 4 who had undergone transplant. All patients had severe anemia (mean hemoglobin level, 5.0 ± 1.9 g/dL). Seven patients who underwent bone-marrow aspiration had positive HPV-B19 polymerase chain reaction (PCR) results at diagnosis. Patients received a mean of 2.7 ± 2.1 IVIG courses (1.3 ± 0.5 g/kg/course). Hemoglobin level was corrected in 9 of the 10 patients within a mean of 80 ± 54 days. The only nonresponsive patient had underlying myelodysplasia. Blood HPV-B19 PCR results were negative from 35 to 159 days after treatment. Four patients showed side effects of IVIG treatment: acute reversible renal failure (n = 2) and pulmonary edema (n = 2). Among 133 patients with HPV-B19 PRCA who received IVIG (our 10 patients and 123 from the literature), 63 had undergone solid-organ transplant and 39 had human immunodeficiency virus infection. Hemoglobin level was corrected after the first IVIG course in 124 patients (93%); disease relapsed in 42 (33.9%), at a mean of 4.3 months.
  
  
  CONCLUSIONS
  IVIG therapy appears to be effective in the short term in immunocompromised patients with HPV-B19 PRCA.
authors.affiliation: Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, France.
authors.forename: Yoann
authors.initials: Y
authors.lastname: Crabol
authors.forename: Benjamin
authors.initials: B
authors.lastname: Terrier
authors.forename: Flore
authors.initials: F
authors.lastname: Rozenberg
authors.forename: Vincent
authors.initials: V
authors.lastname: Pestre
authors.forename: Christophe
authors.initials: C
authors.lastname: Legendre
authors.forename: Olivier
authors.initials: O
authors.lastname: Hermine
authors.forename: Catherine
authors.initials: C
authors.lastname: Montagnier-Petrissans
authors.forename: Loïc
authors.initials: L
authors.lastname: Guillevin
authors.forename: Luc
authors.initials: L
authors.lastname: Mouthon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007167:Immunotherapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D010297:Paris; D010322:Parvoviridae Infections / Q000150:complications* / Q000628:therapy* / Q000821:virology; D016732:Parvovirus B19, Human / Q000302:isolation & purification*; D012010:Red-Cell Aplasia, Pure / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous