Thiếu máu do nhiễm Parvovirus B19 ở trẻ em sau ghép thận: Nhân hai trường hợp

Parvovirus B19 (PV B19) is a nonenveloped single-stranded DNA virus that causes a wide variety of diseases ranging from benign childhood infection such as slapped-cheek syndrome to life threatening diseases such as hydrous fetalis in fetuses or aplastic anemic crises in patients with hemolytic anemia. In immunocompromised hosts including organ transplant recipients, PV B19 has incorporated into red blood cell progenitors, can lead to severe anemia, resistance to erythropoietin therapy, glomerular sclerosis and rejection. Cases: We experienced two cases of aplastic anemia caused by PV B19 infection in pediatric renal transplant recipients. The patients were 15 year-old boy and 9-year-old boy who received allograft kidneys from his mother and his farther. In 1st case, anemia developed 3 months after transplantation, blood transfusion and his serum was positive for PV B19 PCR. In the other, aplastic anemia developed 7 weeks after transplantation, no blood transfusion and his serum PV B19 PCR is positive. They were treated with 400 mg/kg of IVIG for 5 consecutive days. Three months later, both have normal hematocrit levels and stable renal function, no rejection. However, in the 1st case, he had BKV and CMV infection one month later, we adjust immunosuppression therapy, from MMF to Everolimus. Conclusions: These are two cases of PV B19 infection treated successfully with IVIG in pediatric renal transplant recipients. Early diagnosis and appropriate treatment can improve anemia and long term graft survival.