Repozitorij Medicinskog fakulteta Sveučilišta u Zagrebu

Parvovirus B 19 (PVB19) induced pure red cell aplasia (PRCA) in immunocompromised patient after liver transplantation

Mrzljak, Anna and Kardum-Skelin, Ika and Čolić Cvrlje, Vesna and Filipec Kanižaj, Tajana and Šušterčić, Dunja and Guštin, Denis and Kocman, Branislav (2010) Parvovirus B 19 (PVB19) induced pure red cell aplasia (PRCA) in immunocompromised patient after liver transplantation. Collegium Antropologicum, 34 (1). pp. 271-4. ISSN 0350-6134

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    Croatian abstract

    IZOLIRANA APLAZIJA CRVENE KRVNE LOZE UZROKOVANA INFEKCIJOM PARVOVIRUSOM B 19 NAKON TRANSPLANTACIJE JETRE ----- Prikazujemo slučaj izolirane aplazije crvene krvne loze uzrokovane humanim parvovirus B19 (PVB19) kod imunokompromitiranog bolesnika nakon transplantacije jetre. PVB19 je malen, jednolančani DNA virus čije je djelovanje usmjereno na prekursorne eritoidne stanice u koštanoj srži. Manifestacije PVB19 infekcije su raznolike, te ovise o imunološkom statusu bolesnika, a prezentiraju u rasponu od asimptomatskih do teških infekcija i izolirane aplazije crvene krvne loze. Kod transplantiranih bolesnika uzrok izolirane aplazije crvene krvne loze su imunosupresivni lijekovi ili PVB19. U prikazanom slučaju temeljem citološke analize koštane srži uz karakteristični nedostatak zrelih eritoidnih prekursora te verifikacijom PVB19 DNA u krvi postavljena je dijagnoza. Bolesnik je liječen visokim dozama intravenskih ljudskih imunoglobulina što je dovelo do oporavka eritropoeze. Međutim kod transplantiranih bolesnika, radi imunosupresivne terapije postoji nedostatan imunološki odgovor stoga je supresija infekcije PVB19 odgođena što zahtjeva ustrajnost u terapiji u cilju pokušaja reverzije izolirane aplazije crvene krvne loze.

    English abstract

    Presented here is a case of human parvovirus B19 (PVB19) induced pure red-cell aplasia (PRCA) in immunocompromised patient after orthotopic liver transplantation (OLT). PVB19 is a small, single-stranded DNA whose target cell is the erythroid progenitor in bone marrow. Manifestations of PVB19 infection vary with the immunologic status of the patient, ranging from asymptomatic to severe infections and PRCA. Post-transplant PRCA is induced either by immunosuppressive agents or PVB19. In the presented case, bone marrow aspiration characterized by the absence of mature erythroid precursors and detection of PVB19 DNA in blood led to treatment with high-dose intravenous human immunoglobulins (IVIG) and subsequent recovery of erythropoiesis. Due to insufficient antibody response in immunocompromised patients, suppression of the PVB19 infection is delayed and repetitive treatments may be administrated in attempt of reversing PRCA.

    Item Type: Article
    MeSH: Biopsy ; Eosine Yellowish-(YS) ; Humans ; Immunocompromised Host ; Immunoglobulins, Intravenous ; Immunosuppressive Agents/adverse effects ; Liver Transplantation ; Male ; Methylene Blue ; Middle Aged ; Parvoviridae Infections/complications ; Parvoviridae Infections/immunology ; Parvovirus B19, Human/isolation & purification ; Postoperative Complications/immunology ; Postoperative Complications/virology ; Red-Cell Aplasia, Pure/immunology ; Red-Cell Aplasia, Pure/pathology ; Red-Cell Aplasia, Pure/virology ; Viral Load
    Divisions: Katedra za internu medicinu
    Depositing User: Marijan Šember
    Status: Published
    Creators:
    CreatorsEmail
    Mrzljak, Anna
    Kardum-Skelin, Ika
    Čolić Cvrlje, Vesna
    Filipec Kanižaj, Tajana
    Šušterčić, Dunja
    Guštin, Denis
    Kocman, Branislav
    Date: March 2010
    Date Deposited: 21 May 2010
    Last Modified: 23 Sep 2011 18:11
    Subjects: /
    Related URLs:
      URI: http://medlib.mef.hr/id/eprint/783

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