Chronic anemia as a complication of parvovirus B19 infection in a pediatric kidney transplant patient

Pediatr Nephrol. 1997 Jun;11(3):355-7. doi: 10.1007/s004670050296.

Abstract

This is a report of unexplained anemia that persisted for 4 months in an adolescent renal transplant patient receiving immunosuppression that included prednisone, tacrolimus, and mycophenolate mofetil. This patient required monthly blood transfusions for fatigue, palpitations, and hematocrit levels between 15% and 17%. In addition, his posttransplant course was notable for the development of insulin-dependent diabetes mellitus. While receiving low-dose prednisone, he was switched from tacrolimus to cyclosporin and tapered off insulin injections over the next 2 months. At 4.5 months post-transplantation, further diagnostic evaluation was suggestive of parvovirus B19 infection as the cause for our patient's chronic anemia. After testing negative for serum-specific parvovirus B19 IgM and IgG antibodies, parvovirus B19 infection was detected in blood by the polymerase chain reaction. Treatment with intravenous immunoglobulin (1 g/kg per day x 2 days) resulted in normalization of both his reticulocyte count and hematocrit within 6 weeks. At 4 months after receiving the immunoglobulin infusion, he has maintained a normal hematocrit level and stable renal function without requiring further blood transfusions.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anemia / blood
  • Anemia / etiology*
  • Chronic Disease
  • Hematocrit
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Kidney Function Tests
  • Kidney Transplantation / physiology*
  • Male
  • Parvoviridae Infections / blood*
  • Parvovirus B19, Human*
  • Polymerase Chain Reaction

Substances

  • Immunosuppressive Agents