Keywords
Anemia
Kidney transplantation
Parvovirus B19
Persistent anemia
How to Cite
Abstract
Introduction: Parvovirus B19 (B19V) infection is relatively common among transplant recipients, particularly among solid organ transplant (SOT) and hematopoietic stem cell transplant recipients, although it remains an uncommon complication.
Objective: To present a clinically relevant case that may contribute to the experience of healthcare professionals who routinely manage transplant recipients and to provide academic evidence that may inform future clinical protocols.
Case Presentation: A man in his sixth decade of life with a history of advanced kidney disease secondary to autosomal dominant polycystic kidney disease underwent kidney transplantation in 2016. One year after transplantation, he developed complications related to persistent anemia. Malignancy and coinfection with opportunistic pathogens were ruled out. In 2017, B19V infection was confirmed as the etiological diagnosis. Currently, all three hematological cell lines are within acceptable ranges, with no evidence of clinical relapse.
Discussion and Conclusions: B19V infection in kidney transplant recipients may be underestimated. Immunosuppression and an impaired immune response may favor persistent viremia. B19V infection should be considered in the differential diagnosis of unexplained anemia or pancytopenia in transplant recipients. The diagnostic method of choice is polymerase chain reaction (PCR) testing for viral DNA in peripheral blood. Confirmation may be obtained by PCR testing of bone marrow, when clinically indicated. Targeted treatment consists of reducing immunosuppression and administering intravenous human immunoglobulin (IVIG). However, standardized long-term follow-up protocols are currently lacking. Furthermore, it remains unclear whether persistent viremia is associated with clinical recurrence or affects long-term survival or morbidity. Further evidence is needed to establish standardized diagnostic and therapeutic guidelines for B19V infection in the transplant population.
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