Two cases of human parvovirus B19 infection-associated anemia after pediatric liver transplantation
10.3760/cma.j.issn.0254-1785.2019.07.007
- VernacularTitle:儿童肝移植术后微小病毒B19感染相关性贫血二例
- Author:
Ping WAN
1
;
Bijun QIU
;
Mingxuan FENG
;
Feng XUE
;
Lei XIA
;
Yi LUO
;
Lihong GU
;
Yongbing QIAN
;
Jianjun ZHANG
;
Qiang XIA
Author Information
1. 上海交通大学医学院附属仁济医院肝脏外科 200127
- Keywords:
liver transplantation;
children;
parvovirus B19;
pure red cell aplasia
- From:
Chinese Journal of Organ Transplantation
2019;40(7):410-413
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the diagnosis and treatment of parvovirus B19 infection-associated anemia after pediatric liver transplantation (LT) .Methods The clinical data were retrospectively reviewed for 2 children with severe anemia caused by parvovirus B19 infection after LT .Case 1 was a 2-year-old girl with a weight of 10 .7 kg .Classical orthotopic LT was performed due to ornithine carbamoyltransferase deficiency . Hemoglobin level began to progressively decline since Day 2 post-transplantation .And case 2 was a 5-month-old girl with an age of 5 months and a weight of 7 .2 kg .She underwent classic orthotopic LT for biliary atresia and decompensated liver cirrhosis .Hemoglobin level progressively declined at nearly 2 months post-transplantation . Results In case 1 ,bone marrow aspiration was performed at Day 54 post-transplantation .There was pure red cell aplasia and the detection of microvirus B19 nucleic acid was positive .Intravenous immunoglobulin was prescribed at a dose of 2 .5 g/day for 10 days ,tacrolimus was switched to cyclosporine and hemoglobin level spiked from 62 to 105 g/L after one-month treatment .In case 2 ,hemoglobin decreased to 44 g/L at 2 .5 months post-transplantation and the result of polymerase chain reaction of parvovirus B 19 was 9 .7 × 107 copies/ml .Then intravenous immunoglobulin was dosed at 2 .5 g/day for 10 days and hemoglobin level rose to 122 g/L at 25 days after treatment . Hemoglobin level decreased to 63 g/L again at 4 .5 months post-transplantation .Anemia was corrected by intravenous immunoglobulin injection plus a temporary discontinuation of tacrolimus and a reduced dose of tacrolimus .Conclusions Infection of parvovirus B19 can cause pure red cell aplasia after LT in children . Early diagnosis with intravenous immunoglobulin and modification of immunosuppressive regimen can obtain excellent therapeutic efficacies .
