Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literature
Key clinical message 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. Abstract Parvovirus B19‐asso...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | Clinical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ccr3.7906 |
| _version_ | 1797655156863533056 |
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| author | Fatemeh Yaghoubi Davood Dalil Farnaz Tavakoli Seyyed Mohammad Hosseini |
| author_facet | Fatemeh Yaghoubi Davood Dalil Farnaz Tavakoli Seyyed Mohammad Hosseini |
| author_sort | Fatemeh Yaghoubi |
| collection | DOAJ |
| description | Key clinical message 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. Abstract 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. |
| first_indexed | 2024-03-11T17:10:04Z |
| format | Article |
| id | doaj.art-2a0b64024a6a48f185b34ff67eabd80b |
| institution | Directory Open Access Journal |
| issn | 2050-0904 |
| language | English |
| last_indexed | 2024-03-11T17:10:04Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj.art-2a0b64024a6a48f185b34ff67eabd80b2023-10-20T06:16:22ZengWileyClinical Case Reports2050-09042023-09-01119n/an/a10.1002/ccr3.7906Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literatureFatemeh Yaghoubi0Davood Dalil1Farnaz Tavakoli2Seyyed Mohammad Hosseini3Nephrology Research Center, Shariati Hospital Tehran University of Medical Sciences Tehran IranStudent Research Committee, Faculty of Medicine Shahed University Tehran IranNephrology Research Center, Shariati Hospital Tehran University of Medical Sciences Tehran IranStudent Research Committee, Faculty of Medicine Shahed University Tehran IranKey clinical message 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. Abstract 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.https://doi.org/10.1002/ccr3.7906anemiaESRDkidney transplantparvovirus B19 |
| spellingShingle | Fatemeh Yaghoubi Davood Dalil Farnaz Tavakoli Seyyed Mohammad Hosseini Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literature Clinical Case Reports anemia ESRD kidney transplant parvovirus B19 |
| title | Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literature |
| title_full | Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literature |
| title_fullStr | Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literature |
| title_full_unstemmed | Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literature |
| title_short | Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literature |
| title_sort | relapsing anemia associated with parvovirus b19 infection in a kidney transplant recipient a case report and review of the literature |
| topic | anemia ESRD kidney transplant parvovirus B19 |
| url | https://doi.org/10.1002/ccr3.7906 |
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