Nour B, Green M, Michaels M, Reyes J, Tzakis A, Gartner J C, McLoughlin L, Starzl T E
Department of Surgery, University of Pittsburgh Medical Center, Pennsylvania.
Transplantation. 1993 Oct;56(4):835-8. doi: 10.1097/00007890-199310000-00011.
Evidence of recent parvovirus virus infection (as determined by the presence of a positive IgM antibody titer) without other identified causes of anemia was found in 5 of 26 pediatric solid-organ transplant recipients evaluated for moderate-to-severe anemia between June 1990 and July 1991. Anemia tended to be chronic (median duration of anemia at the time of diagnosis was 12 weeks) and was associated with normal red blood cell indices in the absence of reticulocytes. The median age of the children at the time of presentation with anemia due to parvovirus was 1.8 years at a median time of 8 months after transplantation. Four of the 5 children were treated with i.v. immunoglobulin because of persistence of anemia requiring blood transfusions. A response characterized by an increase in reticulocyte count and normalization of hemoglobin was seen in each of these patients 2-4 weeks after treatment. The remaining patient experienced a spontaneous recovery from her anemia. Parvovirus infection should be included in the differential diagnosis of solid-organ transplant recipients presenting with severe anemia associated with low or absent reticulocytes.
在1990年6月至1991年7月期间接受评估的26名患有中度至重度贫血的小儿实体器官移植受者中，有5名发现近期存在细小病毒感染证据（通过IgM抗体滴度呈阳性确定），且无其他已明确的贫血病因。贫血往往呈慢性（诊断时贫血的中位持续时间为12周），在无网织红细胞的情况下，红细胞指数正常。因细小病毒导致贫血的儿童出现症状时的中位年龄为1.8岁，中位时间为移植后8个月。5名儿童中有4名因贫血持续需要输血而接受静脉注射免疫球蛋白治疗。治疗后2 - 4周，这些患者均出现以网织红细胞计数增加和血红蛋白正常化为特征的反应。其余1名患者的贫血自发恢复。对于出现与低网织红细胞或无网织红细胞相关的严重贫血的实体器官移植受者，鉴别诊断中应考虑细小病毒感染。
