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Relapsing severe anaemia due to primary parvovirus B19 infection after renal transplantation: a case report and review of the literature.

In renal transplant recipients Parvovirus B19 (PB19) infection can lead to severe anaemia, due to lytical replication within erythroid progenitor cells. Clearance of PB19-infection and protective immunity is assumed to be provided by specific PB19-IgG-antibodies [1]. In fact, passive transfer of PB19-IgG-antibodies by means of intravenous immunoglobulin (IvIg) preparations is successfully used to treat PB19-related anaemia [1,2]; however, several reports have shown that PB19related anaemia can recur despite treatment with IvIg [2–11]. In this report we describe in detail a renal transplant patient who experienced relapsing severe PB19-related anaemia and we reviewed the current literature regarding factors associated with relapsing disease. Our data suggest that primary PB19-infection after kidney transplantation and polyclonal T-cell depleting therapies are risk factors for relapsing PB19-related anaemia. In addition, they support the concept that a PB19specific cellular immune response is critical to control PB19-infection and establish protective immunity.