J Korean Soc Transplant.  2007 Dec;21(2):302-306.

Pure Red Cell Aplasia (PRCA) due to Parvovirus B19 Infection after Kidney Transplantation

• Kim KY
• Park JH
• Kim CN
• Han SY
• Han KH
• Lee HR
• Um TH

Abstract

The patient was a 39-year-old male with anemia persistent after a living-related renal transplantation. He was diagnosed to have pure red cell aplasia (PRCA) due to parvovirus B19 infection on the 6th week after the renal transplantation. Serum Parvovirus B19 DNA polymerase chain reaction (PCR) and anti-Parvovirus B19 IgM were positive and bone marrow aspiration biopsy showed giant pronormoblasts including prominent intranuclear inclusions. He has been receiving immunosuppressive therapy including oral cyclosporine A, prednisolone, mycophenolate mofetil (MMF). After diagnosis of pure red cell aplasia, we reduced the dose of cyclosporine A and maintained prednisolone, mycophenolate mofetil. We used intravenous immunoglobin(IVIG) 0.4 g/kg/ day for 5 days. Patient's serum reticulocyte count increased a week after the treatment from 0.1% to 3.8%, and patient's serum hemoglobin level normalized on the 4th week of the treatment. Presently, 20 weeks following the initiation of IVIG, his hemoglobin remains normal without recurrent symptom. We are planning to follow up the serum anti-parvovirus B19 IgM/IgG and parvovirus B19 DNA PCR examination.

Keyword

Pure red cell aplasia; Parvovirus B19; Kidney transplantation; intravenous immunoglobulin (IVIG)

MeSH Terms

Adult
Anemia
Biopsy, Needle
Bone Marrow
Cyclosporine
Diagnosis
DNA
Erythroblasts
Follow-Up Studies
Humans
Immunoglobulin M
Immunoglobulins, Intravenous
Intranuclear Inclusion Bodies
Kidney Transplantation*
Kidney*
Male
Parvovirus*
Polymerase Chain Reaction
Prednisolone
Red-Cell Aplasia, Pure*
Reticulocyte Count
Cyclosporine
DNA
Immunoglobulin M
Immunoglobulins, Intravenous
Prednisolone