Refractory Anemia in a Kidney Transplant Recipient

Area of Science:

• Nephrology
• Infectious Diseases
• Hematology

Background:

• Anemia is a frequent complication following kidney transplantation (KT).
• Post-transplant immunosuppression aims to prevent organ rejection but can increase infection susceptibility.

Observation:

• A 34-year-old male kidney transplant recipient developed progressive dyspnea and fatigue one year post-transplant.
• Laboratory findings revealed hypochromic microcytic anemia unresponsive to erythropoiesis-stimulating agents.
• Bone marrow biopsy showed erythroid hyperplasia, and serological tests confirmed active human parvovirus B19 (PVB19) infection.

Findings:

• The patient's anemia was attributed to PVB19 infection, a rare but significant post-transplant complication.
• Treatment involved reducing immunosuppressive therapy and administering intravenous immunoglobulin.
• Anemia resolved within one week, with sustained hemoglobin levels at two months.

Implications:

• PVB19 infection should be considered in the differential diagnosis of anemia in kidney transplant patients.
• Prompt diagnosis and management, including immunosuppression adjustment and immunoglobulin therapy, are crucial for recovery.
• This case highlights the importance of monitoring for opportunistic infections in immunosuppressed transplant recipients.