Abstract:
A 13-year-old girl who had a kidney transplant four weeks prior presented with a 10-day history of fatigue, paleness, and headache. On physical examination, tachycardia and paleness were noted. Laboratory testing was notable for severe anemia and mild leukopenia and thrombocytopenia. Polymerase chain reaction (PCR) test for Epstein-Barr virus (EBV) and cytomegalovirus (CMV) were negative and for parvovirus B19 (PVB19) was positive. Despite lower immunosuppression and administration of intravenous immunoglobulin (IVIG) it persisted for 15 months, and frequent red blood cell transfusions were needed. PVB19 is a less common but significant complication. The patient\'s clinical course demonstrates the importance of this complication and the challenges in its management. A notable void exists in the literature regarding standardized treatment protocols for PVB19-induced recurrent anemia after kidney transplant. This case indicates the need for further research and consensus to guide effective clinical interventions in similar cases.
摘要:
一名13岁女孩在4周前进行了肾脏移植,有10天的疲劳史,苍白,和头痛。在体检时,注意到心动过速和苍白。实验室检查为严重贫血和轻度白细胞减少症和血小板减少症。EB病毒(EBV)和巨细胞病毒(CMV)的聚合酶链反应(PCR)测试为阴性,细小病毒B19(PVB19)为阳性。尽管免疫抑制和静脉注射免疫球蛋白(IVIG)降低,但它持续了15个月,需要频繁的红细胞输血。PVB19是一种不太常见但显著的并发症。患者的临床过程证明了这种并发症的重要性及其管理方面的挑战。关于肾移植后PVB19引起的复发性贫血的标准化治疗方案,文献中存在明显的空白。这种情况表明需要进一步的研究和共识,以指导类似病例的有效临床干预。