Chronic parvovirus B19 infection-associated pure red cell anaemia in a kidney transplant recipient.

Transplant recipients are known to be susceptible to primary viral infections or to reactivation of a persistent virus. Most of the clinically relevant infections are caused by the herpes-viridae group (CMV, EBV, VZV, HSV I and II). Human parvovirus B19 was first discovered 1975 in human packed blood [1] and subsequently shown to cause fifth disease or erythema infectiosum in children [2]. The virus also causes aplastic crises in patients with underlying haemolytic anaemia [3-5]. Chronic parvovirus B19 infection can induce pure red cell anaemia in patients with congenital immunodeficiency, acquired immunodeficiency syndrome, and children with lymphoblastic leukaemia. Pure red cell anaemia due to chronic parvovirus B19 infection has rarely been described in organ transplant recipients: Nour et al. [6] reported on five paediatric liver and heart recipients, Ramage et al. [7] described the case of a liver transplant recipient and in a report on renal effects of immunoglobulin therapy Cantu et al. [8] mentioned a patient with parvovirus B19 infection after combined heart-kidney transplantation. Some of these patients with persistent parvovirus infection were treated successfully with high-dose intravenous immunoglobulin (HD-IVIG).