Chronic anemia as a complication of parvovirus B19 infection in a pediatric kidney transplant patient |
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Authors: | Robert S Mathias |
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Institution: | (1) Children’s Renal Center, Department of Pediatrics, University of California San Francisco Medical Center, San Francisco, California 94143, USA, US |
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Abstract: | . This is a report of unexplained anemia that persisted for 4 months in an adolescent renal transplant patient receiving immunosuppression
that included prednisone, tacrolimus, and mycophenolate mofetil. This patient required monthly blood transfusions for fatigue,
palpitations, and hematocrit levels between 15% and 17%. In addition, his posttransplant course was notable for the development
of insulin-dependent diabetes mellitus. While receiving low-dose prednisone, he was switched from tacrolimus to cyclosporin
and tapered off insulin injections over the next 2 months. At 4.5 months post-transplantation, further diagnostic evaluation
was suggestive of parvovirus B19 infection as the cause for our patient’s chronic anemia. After testing negative for serum-specific
parvovirus B19 IgM and IgG antibodies, parvovirus B19 infection was detected in blood by the polymerase chain reaction. Treatment
with intravenous immunoglobulin (1 g/kg per day × 2 days) resulted in normalization of both his reticulocyte count and hematocrit
within 6 weeks. At 4 months after receiving the immunoglobulin infusion, he has maintained a normal hematocrit level and stable
renal function without requiring further blood transfusions.
Received August 23, 1996; received in revised form and accepted November 20, 1996 |
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Keywords: | : Kidney transplant Immunosuppression Chronic anemia Parvovirus B19 Immunoglobulin |
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