关键词:

人微小病毒 B19V , 肾移植 , 纯红细胞再生障碍性贫血 , 静注人免疫球蛋白

Abstract:

Objective To investigate the clinical characteristics and treatment plans of anemia causedby human parvovirus B19V infection after kidney transplantation. Methods A total number of 5 patients with refractory anemia who underwent kidney transplantation surgery at the Organ Transplantation Center of the 924th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China were observed. Laboratorytests showed small cell hypochromic anemia，and after ruling out common causes of anemia，blood metagenomic next-generation sequencing（mNGS）testing showed positive for human parvovirus B19V. Treatment includederythropoietin，oral iron，intravenous injection of human immunoglobulin（400 mg/kg，d 1 ～ 5），adjusting theimmunosuppressive regimen（partially reducing the dose of tacrolimus，partially adjusting tacrolimus to cyclosporine） and other comprehensive treatments. Results After comprehensive treatment，4 cases among the 5 patients （80%）showed significant improvement in their conditions，1 case experienced recurrence，which was improved after intravenous injection of human immunoglobulin again. During treatment，1 case developed acute rejection reaction. Conclusion After kidney transplantation，patients with unexplained anemia and progressive exacerbationshould be alert to the possibility of human parvovirus B19V infection. Intravenous injection of human immunoglobulin is the preferred treatment method for pure red blood cell aplastic anemia caused by human parvovirus B19V infection after kidney transplantation. For recurrent patients，reapplication is still effective. Combined adjustment of immunosuppressive regimens and other comprehensive treatments can achieve ideal therapeutic effects. During thetreatment period，it is also necessary to closely monitor the functional status of the transplanted kidney to prevent rejection reactions. 

Key words:

"> Human parvovirus B19, Kidney transplantation, Pure red cell aplasia, Intravenousimmunoglobulin