Parvovirus B19 Infection in Two Korean Pediatric Kidney Transplant Patients

Koo, So-Eun; Lee, Joo-Hoon; Hahn, Hye-Won; Han, Duck-Jong; Park, Young-Seo

J Korean Soc Pediatr Nephrol > Volume 9(2); 2005 > Article

J Korean Soc Pediatr Nephrol 2005;9(2): 275-281.

소아에서 신장 이식 후 발생한 Parvovirus Bl9 감염 2례

구소은, 이주훈, 한혜원, 한덕종, 박영서

¹울산대학교 의과대학 서울아산병원 소아과
²울산대학교 의과대학 서울아산병원 소아과
³을지의과대학교 소아과학교실
⁴울산대학교 의과대학 서울아산병원 외과
⁵울산대학교 의과대학 서울아산병원 소아과

Parvovirus B19 Infection in Two Korean Pediatric Kidney Transplant Patients

So-Eun Koo, Joo-Hoon Lee, Hye-Won Hahn, Duck-Jong Han, Young-Seo Park

¹Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine
²Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine
³Department of Pediatics, Eulji University School of Medicine
⁴Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine
⁵Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine

ABSTRACT

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 rash(fifth disease) to life threatening diseases such as hydrops fetalis in fetuses or aplastic anemic crises in patients with hemolytic anemia. In immunocompromised hosts including organ transplant recipients, this infection can cause chronic anemia. Recently, the reports of cases of PV B19 infection have been increasing in transplant recipients and most reported cases of PV B19 infection-associated anemia in renal transplant recipients were successfully treated with intravenous immunoglobulin infusion. We experienced two cases of aplastic anemia caused by PV B19 infection in pediatric renal transplant recipients. The patients were an 8- year-old boy and 12-year-old boy who received allograft kidneys from their mothers. Anemia developed 2 weeks after transplantation and their serum was positive for PV B19 PCR. They were treated with 400 mg/kg of intravenous immunoglobulin(IVIG) for 5 consecutive days. In one of the case, anemia was corrected promptly after the first 5-day course of IVIG therapy but in the other, anemia persisted but responded to the second course of IVIG therapy. One year later, the patients have normal hematocrit levels and stable renal function. These are the first cases of PV B19 infection treated successfully with IVIG in pediatric renal transplant recipients in Korea.

Key words: Parvovirus B19 | Kidney transplantation | Immunoglobulin | Children