Abstract
We studied a case of recurrent PV-B19-associated anemia in a renal transplant child with long-term remission induced by baseline immunosuppression adjusted and intensive IVIG therapy. This was a 15-yr-old boy. Seven wk after transplantation, he experienced acute rejection, which was treated with high-dose steroids, ATG, and plasmapheresis. Ten wk after transplantation (three wk after rejection), his hemoglobin dropped to 54 g/L and serum PV-B19 PCR was positive. After therapy with IVIG and conversion from mycophenolate mofetil to rapamycin, anemia resolved. But the patient had fever on the fourth day of IVIG with mild pulmonary edema and rise in serum creatinine. Two months after the first course of IVIG, anemia recurred and a second course of IVIG (preadministration methylprednisolone) was given, which was followed by the resolution of anemia without side effect and recurrence two months later again. Baseline immunosuppression was adjusted with dual immunosuppression and low doses including prednisolone and tacrolimus. At the same time, monthly course of IVIG was repeated four times. Within the next 23 months, anemia did not recur and renal function remained stable. In conclusion, PV-B19-associated anemia can be recurrent in i...Continue Reading
References
Feb 1, 1993·Transplantation·D A CorralM L Jordan
Jun 1, 1997·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·R S Mathias
Aug 30, 2002·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Dimitrios TsinalisVolker Nickeleit
Feb 6, 2004·The New England Journal of Medicine·Neal S Young, Kevin E Brown
May 7, 2004·The New England Journal of Medicine·Burkhard D BültmannKarin Klingel
Jun 30, 2005·Transplant Infectious Disease : an Official Journal of the Transplantation Society·J KumarS Abul-Ezz
Oct 29, 2005·PLoS Medicine·Adiba IsaPaul Bowness
Nov 5, 2005·Pediatric Transplantation·Mihail M SubtireluMarcela Del Rio
Mar 17, 2006·Renal Failure·Bobby ChackoChakko K Jacob
Sep 19, 2006·Transplantation Proceedings·E RenoultM Kessler
Sep 19, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Meryl Waldman, Jeffrey B Kopp
Sep 25, 2007·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Angelika BeckhoffStefan Schaub
Feb 11, 2009·Clinical Nephrology·S MetallidisP Nikolaidis
Citations
Jul 16, 2011·Néphrologie & thérapeutique·Albane Brodin-SartoriusChristophe Legendre
Aug 31, 2012·Transplant Infectious Disease : an Official Journal of the Transplantation Society·C GossetE Pillebout
Nov 4, 2016·Clinical Microbiology Reviews·Jianming QiuNeal S Young
Dec 12, 2018·Antimicrobial Agents and Chemotherapy·Peng XuJianming Qiu
Jan 12, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·S C JordanA A Vo
Jun 14, 2017·Viruses·Michael WürdingerAnnelie Plentz