Ahsan N, Holman M J, Gocke C D, Groff J A, Yang H C
Department of Medicine, Milton S. Hershey Medical Center, Pennsylvania State University, College of Medicine, Hershey 17033, USA.
Clin Transplant. 1997 Aug;11(4):265-70.
Human parvovirus B19 disease is an infrequent but recognized rare cause of anemia in immunocompromised patients. A few cases of parvovirus B19 infections have been reported in transplant recipients, of those only four patients underwent renal transplantation. The primary immunosuppressive therapy in these patients included prednisone with either cyclosporine or tacrolimus. In one patient the disease was self-limiting, while in three others the hematocrit improved following 10-15 d of treatment with commercial intravenous immunoglobulin (IVIG). Herein, we report the fifth case of pure red cell aplasia due to parvovirus B19 infection in a renal transplant recipient who responded to a 5-d course of IVIG. To our knowledge, this is the first case of parvovirus B19 infection in a patient with solid-organ transplantation whose immunosuppressive regimen included both mycophenolate mofetil and tacrolimus and in whom an excellent clinical response was achieved with a short course of IVIG infusion.
人类细小病毒B19疾病在免疫功能低下的患者中虽不常见,但却是导致贫血的一种公认的罕见病因。已有少数几例细小病毒B19感染在移植受者中被报道,其中仅有4例患者接受了肾移植。这些患者的主要免疫抑制治疗包括泼尼松联合环孢素或他克莫司。1例患者的病情为自限性,而其他3例患者在接受10 - 15天的静脉注射免疫球蛋白(IVIG)治疗后血细胞比容有所改善。在此,我们报告第5例肾移植受者因细小病毒B19感染导致的纯红细胞再生障碍性贫血,该患者对5天疗程的IVIG治疗有反应。据我们所知,这是首例实体器官移植患者感染细小病毒B19,其免疫抑制方案包括霉酚酸酯和他克莫司,且通过短期IVIG输注获得了良好临床反应。