PARVOVIRUS B19 INFECTION-RELATED COMPLICATIONS IN RENAL-TRANSPLANT RECIPIENTS - TREATMENT WITH INTRAVENOUS IMMUNOGLOBULIN

Background. Chronic red cell aplasia can develop in immunocompromised patients including transplant recipients infected with parvovirus B19 (PV B19). Renal involvement with PV B19 infection is not well-recogniz ed, Methods, We diagnosed erythroid hypoplasia associated with PV B19 infection in three renal transplant recipients; one of them developed de novo collapsing glomerulopathy. These patients were treated with in travenous immunoglobulin (IVIG). Results, In two patients, anemia resp onded promptly to IVIG therapy. One of them had recurrence of anemia t hat responded to a second course of IVIG. Despite IVIG treatment, pers istent infection with PV B19, recurrent anemia, and de novo collapsing glomerulopathy leading to allograft failure developed in the third pa tient, who had received the most intense immunosuppression, Conclusion s, These findings indicate that PV B19 infection in transplant recipie nts can cause chronic red cell aplasia that generally responds to IVIG therapy, In some patients, particularly those who are heavily immunos uppressed, infection may persist despite treatment, As the cellular re ceptor for PV B19 is expressed in the kidney, persistent infection may result in development of glomerulopathies in these patients.