Parvovirus B19 infection inducing pure red cells medullary aplasia in kidney transplants patient

Abstract

A 55-year-old man was admitted to the hospital in November 2010 because of an anemia resistant to erythropoietin treatment and scarcely responsive to blood transfusions. The patient had received a kidney transplant 45 days earlier and he was receiving an immunosuppression treatment with steroids, everolimus and tacrolimus. A secondary anemia was ruled out during his stay in the hospital. The clinical hypothesis was a hyporigenerative anemia due to erythropoietin antibodies. The erythropoietin treatment was stopped, the serum erythropoietin was dosed and its value was higher than normally. A bone marrow needle aspiration showed a pure acquired aplasia of the red cells. The parvovirus B19 was detected both in the serum and in the bone marrow. The patient was treated with corticosteroids (prednisone) and i.v. immunoglobulins. A gradual and slow recovery of the aplasia followed.