PURE RED CELL APLASIA AND DIABETES MELLITUS FOLLOWING PARVOVIRUS B19 INFECTION IN A RENAL TRANSPLANT RECIPIENT

Abstract Rituximab is a chimeric monoclonal antibody directed against CD20 and used in the treatment of B-cell non-Hodgkin's lymphoma. Due to its ability to deplete B lymphocytes, rituximab can interfere with humoral immunity, causing it to be suppressed for several months after treatment. The reported case depicts a serious consequence of this effect of rituximab therapy: pure red cell aplasia resulting from chronic parvovirus B19 infection. The point of interest in this case is not only the association between rituximab therapy and pure red cell aplasia, but the diagnostic and therapeutic utility of the knowledge of parvovirus B19 as the likely etiologic link between the two. Given the known efficacy of intravenous immunoglobulin (IVIg) in the treatment of chronic parvovirus B19 infection, this therapy can cure some of these patients and successfully render most others transfusion-independent until recovery of their own humoral immune system.

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Long-term remission of recurrent severe anemia as a result of parvovirus B19 infection in a pediatric renal transplant recipient

Pediatric Transplantation ◽

10.1111/j.1399-3046.2010.01291.x ◽

2010 ◽

Vol 15 (4) ◽

pp. E76-E79 ◽

Cited By ~ 7

Author(s):

Qian Shen ◽

Hong Xu ◽

Qi Cao ◽

Li-Jun Zhou ◽

Jin Xu ◽

...

Keyword(s):

Renal Transplant ◽

Transplant Recipient ◽

Renal Transplant Recipient ◽

Parvovirus B19 ◽

Severe Anemia ◽

Pediatric Renal Transplant ◽

Parvovirus B19 Infection

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Pure red cell aplasia caused by Parvo B19 virus in a kidney transplant recipient

Journal of Nepal Medical Association ◽

10.31729/jnma.73 ◽

2012 ◽

Vol 52 (186) ◽

Cited By ~ 2

Author(s):

A Baral ◽

B Poudel ◽

R K Agrawal ◽

R Hada ◽

S Gurung

Keyword(s):

Bone Marrow ◽

Transplant Recipient ◽

Intravenous Immunoglobulin ◽

Kidney Transplant ◽

Parvovirus B19 ◽

Kidney Transplant Recipient ◽

Pure Red Cell Aplasia ◽

Red Cell ◽

Erythroid Progenitor ◽

Red Cell Aplasia

Parvo B19 is a single stranded DNA virus, which typically has affi nity for erythroid progenitor cells in the bone marrow and produces a severe form of anemia known as pure red cell aplasia. This condition is particularly worse in immunocompromised individuals. We herein report a young Nepali male who developed severe and persistent anaemia after kidney transplantation while being on immunosuppressive therapy. His bone marrow examination revealed morphological changes of pure red cell aplasia, caused by parvovirus B19. The IgM antibody against the virus was positive and the virus was detected by polymerase chain reaction in the blood. He was managed with intravenous immunoglobulin. He responded well to the treatment and has normal hemoglobin levels three months post treatment. To the best of our knowledge, this is the fi rst such case report from Nepal. Keywords: Intravenous immunoglobulin, kidney transplant recipient, Parvovirus B19, pure red cell aplasia.

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