Parvovirus B19 infection causing red cell aplasia in renal transplantation on tacrolimus

Wong, Teresa Yuk‐Hwa; Chan, Paul K.S.; Leung, Chi Bon; Szeto, Cheuk‐Chun; Tam, John S.; Li, Philip K.T.

doi:10.1016/s0272-6386(99)70021-1

Cited by 68 publications

(36 citation statements)

References 12 publications

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“…Several reports have concluded that symptomatic B19 infection is linked specifically to the use of tacrolimus rather than the overall state of immunosuppression. This is based on observations that a switch from tacrolimus to cyclosporine was followed by viral clearance and complete resolution of anemia in some patients (78,96,97). Accordingly, some have suggested this change in drug regimen for infected recipients who fail to respond to IVIG.…”

Section: Treatmentmentioning

confidence: 99%

Parvovirus B19 and the Kidney

Waldman¹,

Kopp²

2007

Clinical Journal of the American Society of Nephrology

116

105

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Section: Treatmentmentioning

confidence: 99%

Parvovirus B19 and the Kidney

Waldman¹,

Kopp²

2007

Clinical Journal of the American Society of Nephrology

116

105

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“…Manipulation of the immune system by changing immunosuppressive regimens in recipients of solid organ transplants or by treating HIV infection with highly active antiretroviral therapy has been anecdotally successful [21,22]. In a series of heterogeneous patients with PRCA, the presence of normal BFU-E growth, as found in our patient, has been associated with positive responses to immunosuppressive agents [17].…”

Section: Discussionmentioning

confidence: 86%

Pure red cell aplasia associated with parvovirus B19 infection occurring late after allogeneic bone marrow transplantation

et al. 2004

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Differential diagnosis for anemia late after allogeneic stem cell transplantation is broad. In this report, we describe a case of severe anemia secondary to pure red cell aplasia associated with human parvovirus B19 infection over 8 years after allogeneic bone marrow transplantation. Characteristics of parvovirus B19 infection and the immunosuppressed state after allogeneic stem cell transplantation are reviewed. Am.

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“…10 Substitution of tacrolimus with cyclosporine was also followed by viral clearance and resolution of anemia. 9,11 Vigilance should be observed during highrisk periods such as early after transplantation and after treatment for rejection, when the dose of immunosuppressants are high. 4 Abbreviations: BP, blood pressure (mm Hg); BMA, bone marrow aspiration; BUN, blood urea nitrogen (mg/dL); Cl, chloride (mEq/L); CMV, cytomegalovirus; Cr, creatinine (mg/dL); EBV, Epstein-Barr virus; FOB, fecal occult blood; Hb, hemoglobin (g/dL); HCO 3 , bicarbonate (mEq/L); Hct, hematocrit (%); HR, heart rate (no of beats/min); K, potassium (mEq/L); LDH, lactate dehydrogenase (IU/L); Na, sodium (mEq/L); OGD, esophagoduodenoscopy; PCR, polymerase chain reaction; Plt, platelet; RBS, random blood sugar (mg/dL); RBC, red blood cells; RR, respiratory rate (per min); TC, total count; Temp, temperature (°F); TIBC, total iron binding capacity.…”

Section: Discussionmentioning

confidence: 99%

Effects of Parvovirus B19 Infection in Renal Transplant Recipients: A Retrospective Review of Three Cases

et al. 2014

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Parvovirus B19 (PVB19) is a DNA virus which causes clinically relevant infection in renal transplant recipients (RTR) leading to significant morbidity. Manifestations include erythropoietin resistant anemia, proteinuria, and glomerulosclerosis in the allograft. Severe infection may require administration of intravenous immunoglobulin, reduction in immunosuppression and transfusions. The major challenge in managing and preventing the infection in RTR involves the act of balancing the decreased level of immunosuppression and the risk of rejection. The objective of this article is to understand the importance of PVB19 infection and its outcome in RTR. We reviewed the medical records of three RTR with confirmed PVB19 infection and recorded patient information including demographics, clinical and laboratory data, management, and outcome. The average time of occurrence of PVB19 infection as transplant was 8.6 weeks and they presented with symptomatic anemia. Elevated creatinine values were noted in two of them. Following treatment, anemia improved and creatinine values returned to baseline. One of them developed an early relapse and had to be treated once again similarly. We emphasize the importance of maintaining a high index of suspicion for PVB19 infection in patients with anemia in the posttransplant phase, especially in patients on higher doses of immunosuppressants. Early and proper treatment can prevent worsening clinical condition and possible effects on the allograft.

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Parvovirus B19 infection causing red cell aplasia in renal transplantation on tacrolimus

Cited by 68 publications

References 12 publications

Parvovirus B19 and the Kidney

Parvovirus B19 and the Kidney

Pure red cell aplasia associated with parvovirus B19 infection occurring late after allogeneic bone marrow transplantation

Effects of Parvovirus B19 Infection in Renal Transplant Recipients: A Retrospective Review of Three Cases

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