Aplasia midollare pura della serie rossa (PRCA) indotta da infezione da Parvovirus B19 in un paziente portatore di trapianto renale. Descrizione di un caso clinico

S. Ibba; M.B. Michittu; M.G. Murgia; B. Onano; A. Ponticelli; D. Olla; A. Pani; M. Badiali; G.B. Piredda

doi:10.33393/gcnd.2012.1108

Authors

S. Ibba S.C. Nefrologia e Dialisi, Azienda Ospedaliera Brotzu, Cagliari
M.B. Michittu SSD Trapianto Renale, Azienda Ospedaliera Brotzu, Cagliari
M.G. Murgia SSD Trapianto Renale, Azienda Ospedaliera Brotzu, Cagliari
B. Onano SSD Trapianto Renale, Azienda Ospedaliera Brotzu, Cagliari
A. Ponticelli S.C. Nefrologia e Dialisi, Azienda Ospedaliera Brotzu, Cagliari
D. Olla S.C. Nefrologia e Dialisi, Azienda Ospedaliera Brotzu, Cagliari
A. Pani S.C. Nefrologia e Dialisi, Azienda Ospedaliera Brotzu, Cagliari
M. Badiali Trapianti Midollo Osseo, Ospedale Microcitemico, Cagliari
G.B. Piredda SSD Trapianto Renale, Azienda Ospedaliera Brotzu, Cagliari

DOI:

https://doi.org/10.33393/gcnd.2012.1108

Keywords:

PRCA (pure red cell aplasia), Parvovirus B19, Renal transplantation

Abstract

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.