Marchand S, Tchernia G, Hiesse C, Tertian G, Cartron J, Kriaa F, Boubenider S, Goupy C, Lecointe D, Charpentier B
Service de Néphrologie, Transplantation et Hémodialyse, Centre Hospitalier Universitaire du Kremlin Bicêtre, France.
Clin Transplant. 1999 Feb;13(1 Pt 1):17-24. doi: 10.1034/j.1399-0012.1999.t01-1-130103.x.
We report a 61-yr-old kidney transplant recipient with human Parvovirus B19 (HPV B19) infection presenting as a severe pancytopenia 1 month after transplantation. Bone marrow aspiration revealed severe erythroid hypoplasia with giant and dystrophic proerythroblasts. Bone marrow cells were positive for HPV B19 DNA detected by polymerase chain reaction (PCR). Pancytopenia resolved shortly after administration of intravenous immunoglobulins. Nineteen cases of HPV B19 infection in organ transplant recipients have been so far reported in the literature. Immunocompromised patients should be considered at risk from developing symptomatic HPV B19 infections. In such patients, specific anti-HPV B19 IgM and IgG antibodies may be absent or transient and therefore their negativity cannot rule out the diagnosis of HPV B19 infestation. Bone marrow smear morphological findings may suggest the diagnosis but testing for viral DNA by PCR is mandatory. Patients may spontaneously recover. However, since specific anti-viral therapy is not currently available, intravenous immunoglobulin administration appears to be the more efficacious treatment.
我们报告了一名61岁的肾移植受者,其在移植后1个月感染人细小病毒B19(HPV B19),表现为严重的全血细胞减少。骨髓穿刺显示严重的红系造血低下,伴有巨大和发育不良的早幼红细胞。通过聚合酶链反应(PCR)检测,骨髓细胞HPV B19 DNA呈阳性。静脉注射免疫球蛋白后不久,全血细胞减少症得到缓解。迄今为止,文献中已报道了19例器官移植受者感染HPV B19的病例。免疫功能低下的患者应被视为有发生症状性HPV B19感染的风险。在这类患者中,可能不存在或短暂存在特异性抗HPV B19 IgM和IgG抗体,因此其阴性结果不能排除HPV B19感染的诊断。骨髓涂片形态学检查结果可能提示诊断,但必须通过PCR检测病毒DNA。患者可能会自发康复。然而,由于目前尚无特异性抗病毒治疗方法,静脉注射免疫球蛋白似乎是更有效的治疗方法。