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.
DessyprisE.N.Aplastic anemia and pure red cell aplasia. Curr Opin Hematol1994; 1(2): 157–61.
2.
TsaiM.H., LeeD.T., ChenH.C. Systemic lupus erythematosus with pure red cell aplasia: a case report. Chung Hua I Hsueh Tsa Chih (Taipei)1993; 52(4): 265–8.
3.
NelsonRPJr., PascuzziR.M.Paraneoplastic syndromes in thymoma: an immunological perspective. Curr Treat Options Oncol2008; 9(4-6): 269–76.
4.
CharlesR.J., SaboK.M., KiddP.G., AbkowitzJ.L.The pathophysiology of pure red cell aplasia: implications for therapy. Blood1996; 87(11): 4831–8.
5.
BiermanP.J., WarkentinP., HutchinsM.R., KlassenL.W.Pure red cell aplasia following ABO mismatched marrow transplantation for chronic lymphocytic leukemia: response to antithymocyte globulin. Leuk Lymphoma1993; 9(1-2): 169–71.
6.
AhsanN., HolmanM.J., GockeC.D.Pure red cell aplasia due to parvovirus B19 infection in solid organ transplantation. Clin Transplant1997; 11(4): 265–70.
7.
BakerR.I., ManoharanA., de LucaE., BegleyC.G.Pure red cell aplasia of pregnancy: a distinct clinical entity. Br J Haematol1993; 85(3): 619–22.
8.
al-AwamiY., SearsD.A., CarrumG.Pure red cell aplasia associated with hepatitis C infection. Am J Med Sci1997; 314(2): 113–7.
9.
CasadevallN., NatafJ., VironB.Pure red-cell aplasia and antierythropoietin antibodies in patients treated with recombinant erythropoietin. N Engl J Med2002; 346(7): 469–75.
10.
MoffattS., YaegashiN., TadaK., TanakaN., SugamuraK.Human parvovirus B19 nonstructural (NS1) protein induces apoptosis in erythroid lineage cells. J Virol1998; 72: 3018–28.
11.
WongT.Y., ChanP.K., LeungC.B., SzetoC.C., TamJ.S., LiP.K.Parvovirus B19 infection causing red cell aplasia in renal transplantation on tacrolimus. Am J Kidney Dis1999; 34: 1132–6.
12.
D'ArenaG., VigliottiM.L., Dell'OlioM.Rituximab to treat chronic lymphoproliferative disorder-associated pure red cell aplasia. Eur J Haematol2009; 82(3): 235–9.
BennettC.L., LuminariS., NissensonA.R.Pure red-cell aplasia and epoetin therapy. N Engl J Med2004; 351(14): 1403–8.
15.
SabellaC., GoldfarbJ.Parvovirus B19 infections. Am Fam Physician1999; 60(5): 1455–60.
16.
PamidiS., FriedmanK., KampalathB., EshoaC., HariharanS.: Human parvovirus B19 infection presenting as persistent anemia in renal transplant recipients. Transplantation2000; 69: 2666–9.
17.
Weigel-KelleyK.A., YoderM.C., SrivastavaA.Recombinant human parvovirus B19 vectors: Erythrocyte P antigen is necessary but not sufficient for successful transduction of human hematopoietic cells. J Virol2001; 75: 4110–6.
18.
Weigel-KelleyK.A., YoderM.C., SrivastavaA.Alpha 5 beta 1 integrin as a cellular coreceptor for human parvovirus B19: Requirement of functional activation of beta 1 integrin for viral entry. Blood2003; 102: 3927–33.
EgbunaO., ZandM.S., ArbiniA., MenegusM., TaylorJ.Acluster of parvovirus B19 infections in renal transplant recipients: A prospective case series and review of theliterature. Am J Transplant2006; 6: 225–31.
