PDF(Pubmed)
Abstract：
Parvovirus B19 is a small (26 nm), nonenveloped, single-stranded DNA (5.6-kb) virus. The only known host for parvovirus B19 is humans. Parvovirus B19 is directly cytotoxic to erythroid precursor cells of the colony- and burst-forming units. Human parvovirus B19 is the etiologic agent of erythema infectiosum and chronic pure red cell aplasia in immunocompromised individuals. Acute parvovirus B19 infection should be suspected in immunocompromised patients, who present with reticulocytopenic hemolytic anemia and thrombocytopenia. Intravenous immunoglobulin (IVIg) is the standard treatment for parvovirus-induced cytopenias. We report two cases of postrenal transplant who presented with reticulocytopenic anemia and were found to have parvovirus infection. They did not respond to conventional treatment with intravenous gamma globulin. Both patients were treated with rituximab with which they had improvement in clinical and hematological parameters. There was no previous documentation of using rituximab in the treatment of parvovirus-triggered autoimmune hemolytic anemia postrenal transplant patients. This article illustrates how rituximab will be helpful in this setting, of course, it is a new thought but requires further studies and validation.
摘要：
细小病毒B19是一个小（26nm），无包裹，单链DNA（5.6kb）病毒。细小病毒B19的唯一已知宿主是人类。细小病毒B19对集落和爆发形成单位的红系前体细胞具有直接细胞毒性。人细小病毒B19是免疫受损个体中感染性红斑和慢性纯红细胞发育不全的病原体。免疫功能低下患者应怀疑急性细小病毒B19感染，患有网织红细胞减少性溶血性贫血和血小板减少症的患者。静脉免疫球蛋白（IVIg）是细小病毒诱导的血细胞减少症的标准治疗方法。我们报告了两例肾移植后出现网织红细胞减少性贫血并被发现患有细小病毒感染的病例。他们对静脉注射丙种球蛋白的常规治疗没有反应。两名患者均接受了利妥昔单抗治疗，其临床和血液学参数均有所改善。以前没有使用利妥昔单抗治疗肾移植后细小病毒引发的自身免疫性溶血性贫血的文献。这篇文章说明了利妥昔单抗将如何在这种情况下有所帮助，当然,这是一个新的想法，但需要进一步的研究和验证。
