实体器官移植后细小病毒B19感染导致单纯红细胞再生障碍性贫血3例并文献复习

Three cases of pure red cell aplasia caused by parvovirus B19 infection after solid organ transplantation and literature review

目的回顾性分析3例实体器官移植术后(1例肾移植、2例肝移植)细小病毒B19感染导致单纯红细胞再生障碍性贫血(pure red cell aplasia,PRCA)的发生、发展、治疗及转归并文献复习。方法3例患者通过典型临床表现、实验室检查、骨穿等确诊,均发现细小病毒DNA阳性,其中例3患者同时合并带状疱疹病毒DNA阳性。治疗上采用调整免疫抑制剂、静脉应用丙种球蛋白、抗病毒、促造血、补充造血原料等综合治疗。结果患者贫血纠正,复查病毒DNA阴性,随访未见复发。结论实体器官移植后PRCA的病因诊断至关重要,综合治疗可起到良好效果。

Objective Retrospective analysis of the occurrence,development,treatment and outcome of three cases of pure red cell aplasia(PRCA)caused by parvovirus B19 after solid organ transplantation and literature review.Methods Three patients were diagnosed by typical clinical manifestations,laboratory tests,and bone marrow aspiration.The parvovirus DNA was found to be positive in all 3 patients,and case 3 was found to be co-infected with herpes zoster virus.The treatment included a combination of immunosuppressive agents,intravenous gamma globulin,antiviral,hematopoietic,and hematopoietic materials supplementation.Results The patient′s anemia was corrected,and the viral DNA became negative.No recurrence was found during follow-up.Conclusions The etiological diagnosis of PRCA after solid organ transplantation is crucial,and comprehensive treatment can have a good effect.