Severe Anemia Due to Parvovirus Infection Following Treatment with Rituximab in a Pediatric Kidney Transplant Recipient: Anemia after Treatment of Rituximab in Kidney Recipient Patient.
10.3339/chikd.2015.19.2.176
- Author:
Seung Yun KIM
1
;
Hyoung Jin LEE
;
Eujin PARK
;
Yo Han AHN
;
Il Soo HA
;
Hae Il CHEONG
;
Hee Gyung KANG
Author Information
1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. kanghg@snu.ac.kr
- Publication Type:Case Report
- Keywords:
Rituximab;
parvovirus;
kidney transplantation;
PRCA;
anemia
- MeSH:
Allografts;
Anemia*;
B-Lymphocytes;
Cadaver;
Child;
Glomerulosclerosis, Focal Segmental;
Herpesvirus 4, Human;
Humans;
Immunoglobulins;
Kidney Transplantation;
Kidney*;
Leukocytes;
Parvoviridae Infections*;
Parvovirus*;
Platelet Count;
Transplantation*;
Viral Load;
Rituximab
- From:Childhood Kidney Diseases
2015;19(2):176-179
- CountryRepublic of Korea
- Language:English
-
Abstract:
Rituximab (RTX), a monoclonal antibody against the B-cell marker CD20, is commonly used as a treatment for antibody-mediated diseases or B-lymphocyte-mediated diseases. Destruction of B cells may reverse the disease course in many conditions; however, patients who are treated with RTX cannot respond appropriately to de novo infection due to lack of B lymphocytes. Here, we report one such case. A 7-year-old renal allograft recipient presented with severe anemia due to parvovirus infection after RTX treatment. The patient had focal segmental glomerulosclerosis and had received cadaveric kidney transplantation 6 months previously. She was treated with high-dose steroid for acute rejection and RTX for Epstein Barr Virus infection 3 months previously. At presentation, her hemoglobin level was 5.4 g/dL and leukocyte and platelet counts were normal. She had microcytic normochromic anemia and high viral load of parvovirus B19(70,578 copies/mL). Intravenous immunoglobulin (200 mg/kg.d) treatment controlled the progression of anemia and parvovirus infection. De novo parvovirus infection during the B lymphocyte-depletion period may have precipitated the severe anemia in this case. Close monitoring of infection is required after RTX therapy.
