The Journal of the Korean Society for Transplantation  2007;21(2):302-306

Pure Red Cell Aplasia (PRCA) due to Parvovirus B19 Infection after Kidney Transplantation.

Kwang Yeon KIM 1 ; Je Hoon PARK ; Chul Nam KIM ; Sang Youb HAN ; Kum Hyun HAN ; Hye Ran LEE ; Tae Hyun UM

Affiliations

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Keywords

Pure red cell aplasia; Parvovirus B19; Kidney transplantation; intravenous immunoglobulin (IVIG)

Country

Republic of Korea

Language

Korean

MeSH

Abstract

The patient was a 39-year-old male with anemia persistent after a living-related renal transplantation. He was diagnosed to have pure red cell aplasia (PRCA) due to parvovirus B19 infection on the 6th week after the renal transplantation. Serum Parvovirus B19 DNA polymerase chain reaction (PCR) and anti-Parvovirus B19 IgM were positive and bone marrow aspiration biopsy showed giant pronormoblasts including prominent intranuclear inclusions. He has been receiving immunosuppressive therapy including oral cyclosporine A, prednisolone, mycophenolate mofetil (MMF). After diagnosis of pure red cell aplasia, we reduced the dose of cyclosporine A and maintained prednisolone, mycophenolate mofetil. We used intravenous immunoglobin(IVIG) 0.4 g/kg/ day for 5 days. Patient's serum reticulocyte count increased a week after the treatment from 0.1% to 3.8%, and patient's serum hemoglobin level normalized on the 4th week of the treatment. Presently, 20 weeks following the initiation of IVIG, his hemoglobin remains normal without recurrent symptom. We are planning to follow up the serum anti-parvovirus B19 IgM/IgG and parvovirus B19 DNA PCR examination.