Abstract
Background: Parvovirus B19 is the agent causing a regenerative anemia in organ transplant recipients, due to their immunodepressive status. The diagnosis is usually confirmed by the presence of virus in the blood and bone marrow via the PCR technique. There is a potential co-infection with other opportunistic viruses in the transplanted patients. However, this population is not routinely screened for Parvovirus B19 infection. Case Report: A 14-year-old male patient who received living-donor kidney transplantation developed a severely progressive and aregenerative anemia four weeks later. PCR of Parvovirus B19 was positive from bone marrow aspiration. There were concomittant CMV and BK virus co-infection. The treatment included a reduction of immunosuppressants, intravenous gamma globulin. Valganciclovir has been prescribed for three months that could negativate the CMV blood load. At the end, there was an eradication of parvovirus in the bone marrow. Conclusion: This first reported case in Viet Nam which informed that infection with Parvovirus B19 should be investigated in the transplanted population when a regenerative anemia is present. Otherwise, a screening strategy for Parvovirus B19 should also be considered.
Highlights
Anemia is a common problem after transplantation
Parvovirus B19 is the agent causing a regenerative anemia in organ transplant recipients, due to their immunodepressive status
This first reported case in Viet Nam which informed that infection with Parvovirus B19 should be investigated in the transplanted population when a regenerative anemia is present
Summary
Anemia is a common problem after transplantation. The underlying causes are multiple that ranged from regenerative (bleeding, haemolysis) to hypo-regenerative anemia (myelotoxic medication, viral opportunistic infection, graft dysfunction, poor nutritional status) [1]. Severe manifestations due to Parvovirus B19 in transplant recipients have usually been linked to their immunodepressive status [3] [4]. Identification of the viral DNA in the serum or in the bone marrow by PCR is preferred for diagnosis in the transplanted recipients [6]. Therapy is indicated and composed of the infusions of gamma globulin and reduction of immunosuppressive medication. We reported a clinical case of a 14-year-old boy who developed a red cell aplastic crisis 2 months after kidney transplantation due to Parvovirus B19, and has completely recovered under treatment
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