PMID- 34881070
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211211
IS  - 2090-6943 (Print)
IS  - 2090-6951 (Electronic)
IS  - 2090-6951 (Linking)
VI  - 2021
DP  - 2021
TI  - Parvovirus B19 Infection due to over Immunosuppression in Kidney Transplant 
      Recipients: Case Reports and Literature Review.
PG  - 7651488
LID - 10.1155/2021/7651488 [doi]
LID - 7651488
AB  - Parvovirus B19 (PB19) is a single-stranded DNA virus that belongs to the 
      Erythrovirus genus within the Parvoviridae family. Clinical presentations 
      associated with PB19 infection vary greatly, depending on the infected 
      individual's age and hematologic and immunologic status. The limited data 
      available regarding consensus on screening algorithms and indications in donors 
      and recipients prior to kidney transplantation makes diagnosis and management 
      challenging. We presented 3 cases of pure red cell aplasia due to parvovirus B19 
      after kidney transplant. These patients were diagnosed with severe normocytic, 
      normochromic anemia (hemoglobin below 60 g/L) in the 1(st) 6 months 
      posttransplant. A complete anemia work-up revealed low reticulocyte count and was 
      otherwise inconclusive. All patients were diagnosed with pure red cell aplasia 
      due to parvovirus B19. Two patients improved after receiving intravenous 
      immunoglobulin 2 gm/kg given over 4 doses. Unfortunately, they relapse after few 
      weeks and required additional doses of intravenous immunoglobulin in conjugation 
      with reduction of their immunosuppressive medication. The third patient improved 
      after holding mycophenolate mofetil (MMF) and did not require intravenous 
      immunoglobulin. Whereas PB19 infection is typically self-limiting and associated 
      with positive IgM serology in immunocompetent hosts, these cases highlight the 
      importance of considering PB19 infection in the differential diagnosis of 
      persistent anemia in immunocompromised patients and the challenges in confirming 
      the diagnosis. Intravenous immunoglobulin (IVIG) can be an effective treatment in 
      immunocompromised patients with primary or relapsed PB19 infection in conjunction 
      with minimizing immunosuppressive medication. Further research and consideration 
      are required to determine appropriate and targeted screening in donors and 
      recipients in the peritransplantation period.
CI  - Copyright (c) 2021 Abdulrahman Altheaby et al.
FAU - Altheaby, Abdulrahman
AU  - Altheaby A
AUID- ORCID: 0000-0003-1832-6706
AD  - Organ Transplant Center and Hepatobiliary Sciences Department, King Saud bin 
      Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, 
      Saudi Arabia.
FAU - Alotaibi, Malak
AU  - Alotaibi M
AUID- ORCID: 0000-0003-0840-4707
AD  - Department of Medicine, King Saud bin Abdulaziz University for Health Science, 
      King Abdulaziz Medical City, Riyadh, Saudi Arabia.
FAU - Alajlan, Nuha
AU  - Alajlan N
AUID- ORCID: 0000-0002-6553-1908
AD  - College of Medicine, King Saud bin Abdulaziz University for Health Sciences, 
      Riyadh, Saudi Arabia.
FAU - Alshareef, Ala
AU  - Alshareef A
AUID- ORCID: 0000-0001-6913-0362
AD  - Organ Transplant Center and Hepatobiliary Sciences Department, King Saud bin 
      Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, 
      Saudi Arabia.
FAU - Alruwaymi, Mohammed
AU  - Alruwaymi M
AUID- ORCID: 0000-0002-9637-0019
AD  - Organ Transplant Center and Hepatobiliary Sciences Department, King Saud bin 
      Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, 
      Saudi Arabia.
FAU - Aboalsamh, Ghaleb
AU  - Aboalsamh G
AD  - Organ Transplant Center and Hepatobiliary Sciences Department, King Saud bin 
      Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, 
      Saudi Arabia.
FAU - Shaheen, Mohammed F
AU  - Shaheen MF
AD  - Organ Transplant Center and Hepatobiliary Sciences Department, King Saud bin 
      Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, 
      Saudi Arabia.
FAU - Alzunitan, Mohammed
AU  - Alzunitan M
AUID- ORCID: 0000-0002-6012-1811
AD  - Infection Prevention and Control Program, King Saud bin Abdulaziz University for 
      Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
FAU - Arabi, Ziad
AU  - Arabi Z
AD  - Organ Transplant Center and Hepatobiliary Sciences Department, King Saud bin 
      Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, 
      Saudi Arabia.
LA  - eng
PT  - Case Reports
DEP - 20211129
PL  - United States
TA  - Case Rep Transplant
JT  - Case reports in transplantation
JID - 101591863
PMC - PMC8648477
COIS- The authors declare that they have no conflicts of interest.
EDAT- 2021/12/10 06:00
MHDA- 2021/12/10 06:01
PMCR- 2021/11/29
CRDT- 2021/12/09 07:03
PHST- 2021/10/02 00:00 [received]
PHST- 2021/11/09 00:00 [accepted]
PHST- 2021/12/09 07:03 [entrez]
PHST- 2021/12/10 06:00 [pubmed]
PHST- 2021/12/10 06:01 [medline]
PHST- 2021/11/29 00:00 [pmc-release]
AID - 10.1155/2021/7651488 [doi]
PST - epublish
SO  - Case Rep Transplant. 2021 Nov 29;2021:7651488. doi: 10.1155/2021/7651488. 
      eCollection 2021.