Laurenz M, Winkelmann B, Roigas J, Zimmering M, Querfeld U, Müller D
Department of Pediatric Nephrology, Charité Universitätsmedizin, Berlin, Germany.
Pediatr Transplant. 2006 Dec;10(8):978-81. doi: 10.1111/j.1399-3046.2006.00599.x.
Human parvovirus B19 is a common cause of benign erythema infectiosum (fifth disease) in otherwise healthy children. Immunocompromized patients are at risk of developing chronic infections leading to chronic hyporegenerative anemia. We report the case of a nine-year-old boy who presented five days after renal transplantation with seizures and signs of encephalitis on MRI. The clinical course was characterized by anemia and seroconversion for parvovirus B19 accompanied by a high viral load (>10(9) copies per milliliter). A transfusion of red blood cells that the patient required after transplantation was found to be negative for parvovirus B19, leaving the donated organ as the most likely source of infection. Reduction of the immunosuppressive regimen led to complete recovery of the patient with a stable RBC count upon discharge. Parvovirus B19 infections should be considered in the differential diagnosis of seizures after solid organ transplantation.
人细小病毒B19是原本健康儿童良性传染性红斑（第五病）的常见病因。免疫功能低下的患者有发生慢性感染并导致慢性再生障碍性贫血的风险。我们报告了一名9岁男孩的病例，该男孩在肾移植术后5天出现癫痫发作，磁共振成像（MRI）显示有脑炎体征。临床过程的特征为贫血以及细小病毒B19血清学转换，同时病毒载量很高（每毫升>10⁹拷贝）。发现患者移植后所需的红细胞输血检测细小病毒B19呈阴性，因此捐赠器官最有可能是感染源。减少免疫抑制方案后，患者完全康复，出院时红细胞计数稳定。在实体器官移植后癫痫发作的鉴别诊断中应考虑细小病毒B19感染。
