Clinical features of pure red cell aplasia associated with human parvovirus B19 infection after liver transplantation

Objective To investigate the clinical features of patients with pure red cell aplasia( PRCA) associated with human parvovirus B19( HPV B19) infection after liver transplantation. Methods The clinical data of 420 patients who underwent liver transplantation in 302 Hospital of PLA from July 2007 to July 2016 and were followed up regularly were collected,and among these patients,five had a progressive reduction in hemoglobin( Hb) level within a short period of time. Bone marrow cytological examination showed erythropoiesis disorders and positive HPV B19 Ig M,and the patients were diagnosed with PRCA after the exclusion of other causes. The patients were given human gamma- globulin,glucocorticoids,and adjustment of immunosuppressants. The patients' clinical manifestations during treatment and the changes in reticulocyte count( RC),Hb,white blood cell count( WBC),platelet count( PLT),and myelogram findings determined by peripheral blood cell analysis were observed,as well as the changes in liver and renal function parameters. Results After the multimodality therapy using human gamma- globulin,glucocorticoids,and red blood cell infusion,the five patients had significant alleviation in the symptoms of weakness,short breath,and dizziness,and the peripheral blood cell analysis showed recovery of Hb and RC,suggesting that anemia was corrected. Conclusion As for patients with PRCA associated with HPV B19 infection,early diagnosis and treatment with human gamma-globulin and glucocorticoids can achieve a good therapeutic effect.