Korean Journal of Nephrology 2001;20(4):707-713.

증례 : 신장이식 후 나타난 Parvovirus B19 감염에 의한 순수적혈구형성부전증 1 예 (Case Reports : A Case of Persistent Anemia in a Renal Transplant Patient - Parvovirus B19 Infection)

최상호(Sang Ho Choi),장상필(Sang Pil Chang),원종철(Jong Chul Won),이준승(Jun Seung Lee),양원석(Won Seok Yang),지현숙(Hyun Sook Chi),박수길(Su Kil Park)

Abstract

We report an unexplained anemia that persisted for 4 months in a renal transplant patient who was receiving immunosuppression therapy that included prednisolone, tacrolimus, and azathioprine. A bone marrow biopsy demonstrated pure erythroid hypoplasia and occasional giant pronormoblasts with intranuclear inclusions, characteristic of a parvovirus B19 infection. Both the serum and bone marrow cells were positive for a parvovirus B19 DNA polymerase chain reaction. The anemia resolved 6 weeks after the administration of IV immunoglobuln. But, 4 months later, refractory anemia developed and persisted despite treatment with IV immunoglobulin. However, the patient showed rapid improvement after tacrolimus was switched to cyclosporin A. A parvovirus B19 infection should be included in the differential diagnosis of renal transplant recipients who present with an anemia associated with low reticulocytes, and clinicians should be awared that tacrolimus m;iy impair the clearance of a parvovirus B19 infection.