잠시만 기다려 주세요. 로딩중입니다.

Recurrent parvovirus B19 infection-associated pure red cell aplasia in a kidney transplant patient

대한이식학회지 2020년 34권 3호 p.199 ~ 203
Gang Su-Jin, 박수용, 민상일, 홍준식, 장윤환, 하종원, 양재석,
소속 상세정보
 ( Gang Su-Jin ) - Seoul National University Hospital Department of Surgery
박수용 ( Park Soo-Yong ) - Seoul National University Hospital Department of Laboratory Medicine
민상일 ( Min Sang-Il ) - Seoul National University Hospital Department of Surgery
홍준식 ( Hong Joon-Shik ) - Seoul National University Hospital Department of Internal Medicine
장윤환 ( Chang Yoon-Hwan ) - Seoul National University Hospital Department of Laboratory Medicine
하종원 ( Ha Jong-Won ) - Seoul National University Hospital Department of Surgery
양재석 ( Yang Jae-Seok ) - Seoul National University Hospital Department of Surgery

Abstract


Posttransplant anemia is a common complication after kidney transplantation. Parvovirus B19 (PVB19) infection can induce pure red cell aplasia (PRCA) in immunosuppressed transplant patients. We herein report a case of recurrent PVB19-associated PRCA in a kidney transplant patient. A 49-year-old woman presented with anemia and normal renal function 1 year after a deceased-donor kidney transplantation for immunoglobulin A nephropathy- related end-stage renal disease. She received desensitization therapy, and 2 years later, she underwent transplantation with thymoglobulin induction. Despite repeated red cell transfusion and erythropoietin therapy, her anemia aggravated progressively. Bone marrow biopsy revealed normocytic normochromic PRCA. Real-time polymerase chain reaction detected a high plasma load of PVB19. Administration of intravenous immunoglobulin (IVIG) at 2 g/kg with adjuvant reduction of tacrolimus and discontinuation of myfortic acid effectively treated the anemia. However, the PVB19 load remained high, and PRCA recurred 7 months after the initial IVIG treatment. Tacrolimus was switched to cyclosporine in the second IVIG treatment, which successfully improved PRCA and reduced the PVB19 load. Our case suggested that PVB19-associated PRCA should be suspected when persistent anemia is observed in kidney transplant patients with heavy immunosuppression and that PVB19-associated PRCA can recur in the presence of persistent PVB19 viremia.

키워드

Intravenous immunoglobulin; Kidney transplantation; Parvovirus B19 infection; Pure red cell aplasia

원문 및 링크아웃 정보

등재저널 정보