A Case of Persistent Anemia in a Renal Transplant Patient - Parvovirus B19 Infection.
- Author:
Sang Ho CHOI
1
;
Sang Pil CHANG
;
Jong Chul WON
;
Jun Seung LEE
;
Won Seok YANG
;
Hyun Sook CHI
;
Su Kil PARK
Author Information
1. Department of Internal Medicine, College of Medicine, Ulsan University, Seoul, Korea. skpark@www.amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Parvovirus B19;
Kidney transplantation;
Pure red cell aplasia;
Tacrolimus;
Intravenous immunoglobulins
- MeSH:
Anemia*;
Anemia, Refractory;
Azathioprine;
Biopsy;
Bone Marrow;
Bone Marrow Cells;
Cyclosporine;
Diagnosis, Differential;
DNA;
Erythroblasts;
Humans;
Immunoglobulins;
Immunoglobulins, Intravenous;
Immunosuppression;
Intranuclear Inclusion Bodies;
Kidney Transplantation;
Parvovirus*;
Polymerase Chain Reaction;
Prednisolone;
Red-Cell Aplasia, Pure;
Reticulocytes;
Tacrolimus;
Transplantation
- From:Korean Journal of Nephrology
2001;20(4):707-713
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We report an unexplained anemia that persisted for 4 months in a renal transplant patient who was receiving immunosuppression therapy that included prednisolone, tacrolimus, and azathioprine. A bone marrow biopsy demonstrated pure erythroid hypoplasia and occasional giant pronormoblasts with intranuclear inclusions, characteristic of a parvovirus B19 infection. Both the serum and bone marrow cells were positive for a parvovirus B19 DNA polymerase chain reaction. The anemia resolved 6 weeks after the administration of IV immunoglobuln. But, 4 months later, refractory anemia developed and persisted despite treatment with IV immunoglobulin. However, the patient showed rapid improvement after tacrolimus was switched to cyclosporin A. A parvovirus B19 infection should be included in the differential diagnosis of renal transplant recipients who present with an anemia associated with low reticulocytes; and clinicians should be awared that tacrolimus may impair the clearance of a parvovirus B19 infection.
