Abstract
BackgroundParvovirus B19 presents tropism for human erythroid progenitor cells, causing chronic anemia in organ transplant recipients, due to their suppressed humoral and cellular responses. Diagnosis may be achieved through serological tests for detection of anti-B19 antibodies. However, renal transplant recipients are not routinely tested for parvovirus B19 infection, since there is scanty data or consensus on screening for B19 infection, as well as for treatment or preventive management of transplanted patients.Case presentationHerein we report a kidney transplant recipient, who was unresponsive to treatment of severe anemia, and presented hypocellular hematopoietic marrow, megaloblastosis and hypoplasia of erythroid lineage with larger cells with clear nuclei chromatin and eosinophilic nuclear inclusions. This patient was seropositive for Epstein-Barr and Cytomegalovirus infections and negative for anti-parvovirus B19 IgM and IgG antibodies, although symptoms were suggestive of parvoviruses infection. A qualitative polymerase chain reaction testing for B19 in serum sample revealed positive results for B19 virus DNA.ConclusionThis case report suggests that the diagnostic process for parvovirus B19 in renal transplant recipients should include a polymerase chain reaction assay to detect B19-DNA, since specific serological tests may be unreliable given their impaired humoral responses. These results also indicate the importance of considering parvovirus B19 infection in the differential diagnosis of persistent anemia in transplanted patients.
Highlights
Parvovirus B19 presents tropism for human erythroid progenitor cells, causing chronic anemia in organ transplant recipients, due to their suppressed humoral and cellular responses
This case report suggests that the diagnostic process for parvovirus B19 in renal transplant recipients should include a polymerase chain reaction assay to detect B19-DNA, since specific serological tests may be unreliable given their impaired humoral responses
These results indicate the importance of considering parvovirus B19 infection in the differential diagnosis of persistent anemia in transplanted patients
Summary
Parvovirus B19 infection should be considered for the differential diagnosis of persistent anemia non responsive to erythropoietin, aplastic crisis and other opportunist infections in transplanted patients. The true incidence of this infection may be underestimated, because B19 serology may not be routinely searched in transplanted patients. Since serological tests may fail to detect B19 infection in immunosuppressed patients, addition of a polymerase chain reaction assay to detect B19 DNA should be considered to improve sensitivity and to guide adequate treatment. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Authors’ contributions MTA reviewed the patient’s medical record, analyzed data from the literature and wrote the article. SSV followed up the patient during the hospitalization and reviewed the manuscript. MGC, APF and LMSD analyzed data from the literature and reviewed the manuscript. All authors read and approved the final manuscript
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
