소아에서 신장 이식 후 발생한 Parvovirus B19 감염 2례
Parvovirus B19 Infection in Two Korean Pediatric Kidney Transplant Patients
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초록
저자들은 생체신장이식을 받은 후 발열과 빈혈을 주소로 내원한 2명의 환아에서 혈청 PCR을 통해 PV B19 감염을 진단한 후 면역글로불린 정맥투여로 성공적으로 치료하고 재발 없이 관찰 중인 2례를 경험하였기에 보고하는 바이다.
Abstract
Parvovirus B19(PV B19) is a nonenveloped single-stranded DNA virus that causes a wide variety of diseases ranging from benign childhood infection such as slapped-cheek rash(fifth disease) to life threatening diseases such as hydrops fetalis in fetuses or aplastic anemic crises in patients with hemolytic anemia. In immunocompromised hosts including organ transplant recipients, this infection can cause chronic anemia. Recently, the reports of cases of PV B19 infection have been increasing in transplant recipients and most reported cases of PV B19 infection-associated anemia in renal transplant recipients were successfully treated with intravenous immunoglobulin infusion. We experienced two cases of aplastic anemia caused by PV B19 infection in pediatric renal transplant recipients. The patients were an 8- year-old boy and 12-year-old boy who received allograft kidneys from their mothers. Anemia developed 2 weeks after transplantation and their serum was positive for PV B19 PCR. They were treated with 400 mg/kg of intravenous immunoglobulin(IVIG) for 5 consecutive days. In one of the case, anemia was corrected promptly after the first 5-day course of IVIG therapy but in the other, anemia persisted but responded to the second course of IVIG therapy. One year later, the patients have normal hematocrit levels and stable renal function. These are the first cases of PV B19 infection treated successfully with IVIG in pediatric renal transplant recipients in Korea.
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