■PB19感染应被视为肾移植受者移植后贫血的罕见原因,尤其是那些贫血与常见病因无关的患者。IVIG治疗和减少免疫抑制可能是有益的。
■细小病毒B19相关的复发性贫血在肾移植受者中很少见。在这里,我们报道一例53岁女性肾移植术后18个月后因细小病毒B19感染导致复发性贫血的病例.病人出现心悸,呼吸急促,头晕,弱点,和嗜睡。早期实验室发现白细胞计数为6.000/μL,红细胞计数1.89/μL,血红蛋白(Hb)3.5g/dL,血细胞比容(Hct)15%,血小板计数266.000/μL,MCV89,网织红细胞计数0.8%,和血清铁221μg/dL。经进一步评估,BK多瘤病毒和巨细胞病毒(CMV)的RT-PCR检测均为阴性,而细小病毒B19RT-PCR阳性。患者接受输血和IVIG治疗,每天25g,持续5天。出院后两个月,患者出现,抱怨心悸,呼吸急促,头晕,红细胞2.7/μL,Hb6.5g/dL,Hct25%,MCV85再一次,CMVRT-PCR阴性,而细小病毒B19RT-PCR阳性。停用他克莫司和霉酚酸,和IVIG25g每天给药5天。因此,她的Hb水平增加到9g/dL,患者出院时使用泼尼松龙5mg/天和环孢素50mg/天代替他克莫司。病毒感染,特别是PB19感染,在KTRs移植后贫血的鉴别诊断中应予以考虑。建议IVIG治疗和免疫抑制药物的修饰是此类患者的标准疗法。在治疗期间应仔细监测移植肾脏的功能。
UNASSIGNED: PB19 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.
UNASSIGNED: Parvovirus 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.