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肝移植患者人类微小病毒B19感染与相关贫血的临床特点分析

Clinical characteristic analysis on anemia associated with human parvovirus B19 infection in liver transplant recipients

  • 摘要: 目的:探讨肝移植术后人类微小病毒B19(human parvovirus B19, HPV B19)感染致纯红细胞再生障碍性贫血(pure red cell aplasia, PRCA)的诊断和治疗方法。方法:描述和分析19例肝移植术后HPV B19感染引起的PRCA病例的临床特点、诊断、治疗及预后。结果:19例肝移植受者术后2个月内出现贫血,排除导致贫血的其他原因,经实时定量聚合酶链反应(quantitative real-time polymerase chain reaction, qRT-PCR)检测HPV B19 DNA诊断为HPV B19感染致PRCA。所有患者给予静脉注射用免疫球蛋白(intravenous immunoglobulins, IVIG)等治疗后,贫血症状得到改善。结论:对于肝移植术后早期不明原因的PRCA患者,排除其他病因后可考虑HPV B19感染可能。PCR检测HPV B19 DNA是诊断PRCA的主要依据。早期应用IVIG治疗对于治疗肝移植后HPV B19感染相关的PRCA效果良好。

     

    Abstract: Objective:To detect the diagnosis and therapy of pure red cell aplasia (PRCA) associated with human parvovirus B19 (HPV B19) after liver transplantation operation. Methods:The clinical characters, diagnosis, therapy, and prognosis of 19 liver transplant recipients confirmed to have PRCA induced by HPV B19 infection were described and analyzed. Results:Nineteen liver transplantation recipients were reported to have anemia within 2 months after surgery. The patients were diagnosed as PRCA by quantitative real-time polymerase chain reaction (qRT-PCR), and other possible causes for anemia were excluded. All recipients achieved remission after the intravenous immunoglobulins (IVIG) treatment. Conclusions:For patients with unexplained PRCA early after liver transplantation, the possibility of HPV B19 infection should be considered after other possible causes are excluded. PCR detection for HPV B19 is the main method for the diagnosis of PRCA. Early treatment with IVIG can achieve a good therapeutic effect on PRCA associated with HPV B19 after liver transplantation.

     

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