Parvovirus: Uncommon Causes of Anemia and Kidney Failure in a Kidney Transplant Patient

Yarmohamadi, Maliheh; Yaghoubi, Fatemeh

doi:10.5812/numonthly.112713

Cited by 2 publications

(1 citation statement)

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“…Fever, rash, arthralgia, normochromic normocytic anemia, and lack of response to erythropoietin are the most common manifestations of PB19 infection in immunosuppressed patients 10 . PB19 infection may involve other organs, leading to myocarditis, pneumonitis, hepatitis, and graft failure 3,11 . In our patient, the clinical suspicion of erythrocyte‐involving infection, such as PB19, was raised due to the decrease in erythrocyte levels as well as the lack of evidence of common causes of anemia, including gastrointestinal or urinary bleeding, hemolysis, or malnutrition.…”

Section: Discussionmentioning

confidence: 99%

Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literature

Yaghoubi,

Dalil,

Tavakoli

et al. 2023

Clinical Case Reports

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Key clinical messagePB19 infection should be considered an uncommon cause of posttransplant anemia in renal transplant recipients, particularly those whose anemia is not associated with common etiologies. IVIG treatment and reduced immunosuppression could be beneficial.AbstractParvovirus B19‐associated relapsing anemia is rare in kidney transplant recipients. Herein, we report a case of relapsed anemia due to parvovirus B19 infection in a 53‐year‐old woman 18 months after kidney transplantation. The patient presented with palpitations, shortness of breath, dizziness, weakness, and lethargy. Early laboratory findings showed a WBC count of 6.000/μL, RBC count of 1.89/μL, hemoglobin (Hb) 3.5 g/dL, hematocrit (Hct) 15%, platelet count 266.000/μL, MCV 89, reticulocyte count 0.8%, and serum iron 221 μg/dL. Upon further evaluation, the RT‐PCR test for BK polyomavirus and cytomegalovirus (CMV) was negative, while the parvovirus B19 RT‐PCR was positive. The patient was treated with blood transfusion and IVIG 25 g daily for 5 days. Two months after discharge, the patient presented, complaining of palpitation, shortness of breath, and dizziness, with RBC 2.7/μL, Hb 6.5 g/dL, Hct 25%, and MCV 85. Again, the CMV RT‐PCR was negative, while the parvovirus B19 RT‐PCR was positive. Tacrolimus and mycophenolic acid were stopped, and IVIG 25 g daily for 5 days was administered. Consequently, her Hb level increased to 9 g/dL, and the patient was discharged with prednisolone 5 mg daily and cyclosporine 50 mg daily instead of tacrolimus. Viral infection, particularly PB19 infection, should be considered in the differential diagnosis of posttransplantation anemia in KTRs. IVIG treatment and modification of immunosuppressive medications are suggested standard therapies for such patients. The function of transplanted kidneys should be carefully monitored during treatment.

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Section: Discussionmentioning

confidence: 99%