Singh Vishal, Dogra Pavitra Manu, Singh Pulkit, Singh Shamresh Kumar, Ghosh Indranil, Sreenivasa S, Singhal Gaurav, Arya Rohan
Professor & Head (Nephrology), Army Hospital (R&R), Delhi Cantt, India.
Senior Advisor (Medicine) & Nephrologist, Army Hospital (R&R), Delhi Cantt, India.
Med J Armed Forces India. 2023 Nov-Dec;79(6):665-671. doi: 10.1016/j.mjafi.2023.08.005. Epub 2023 Aug 31.
Parvovirus B19 is an uncommon cause of anaemia in kidney transplant recipients (KTRs). The study aims to determine the incidence, clinical presentation, laboratory findings and outcome of parvovirus B19-related anaemia in KTR.
We conducted a 12-year retrospective, single-centre study describing the clinical profile of KTRs with parvovirus B19-related anaemia.
Amongst the 714 patients who underwent kidney transplantation between January 2011 and January 2023, (cumulative follow-up: 1287 patient-years), six females and one male, developed parvovirus B19-related anaemia. The incidence proportion (risk) is 0.98% with an incidence rate of 5.43 cases per 1000 patient-year. The median duration from transplant to development of anaemia was 6 weeks (range: 4-40 weeks). The mean fall in haemoglobin was 2.88 ± 1.55 gm/dl; concomitant leukopenia and thrombocytopenia were observed in 57.1 and 28.6% of patients. Three patients responded to a reduction in immunosuppression, the four non-responders required the administration of low-dose intravenous immunoglobulin. The mean duration from initiation of therapy to a sustained rise in haemoglobin was 7.71 ± 2.62 weeks. None of the patients had a relapse of the infection.
Parvovirus B19 infection is an uncommon cause of post-transplant refractory anaemia. The key to successfully managing such patients includes a high index of suspicion, early diagnosis and reduction of immunosuppression with or without administration of intravenous immunoglobulin.
细小病毒B19是肾移植受者(KTRs)贫血的罕见病因。本研究旨在确定KTR中细小病毒B19相关贫血的发病率、临床表现、实验室检查结果及预后。
我们进行了一项为期12年的回顾性单中心研究,描述了患有细小病毒B19相关贫血的KTR的临床特征。
在2011年1月至2023年1月期间接受肾移植的714例患者中(累计随访:1287患者年),6名女性和1名男性发生了细小病毒B19相关贫血。发病率为0.98%,发病率为每1000患者年5.43例。从移植到发生贫血的中位时间为6周(范围:4 - 40周)。血红蛋白平均下降2.88±1.55 g/dl;57.1%的患者伴有白细胞减少,28.6%的患者伴有血小板减少。3例患者对免疫抑制的降低有反应,4例无反应者需要给予小剂量静脉注射免疫球蛋白。从开始治疗到血红蛋白持续升高的平均时间为7.71±2.62周。所有患者均未出现感染复发。
细小病毒B19感染是移植后难治性贫血的罕见病因。成功管理此类患者的关键包括高度怀疑、早期诊断以及在使用或不使用静脉注射免疫球蛋白的情况下降低免疫抑制。