Exploring parvovirus B19 pathogenesis and therapy among kidney transplant recipients: case report and review of literature

We report the case of a 34-year-old male recipient of an ABO-incompatible living donor kidney transplant who was repeatedly hospitalised for anaemia. Acute kidney injury in a patient with severe and recurrent anaemia related to parvovirus B19 infection was diagnosed through viral and histopathological analysis. In view of the patient's impaired immune response due to the immunosuppressive regimen, clinical stabilisation was reached by repeated intravenous immunoglobulin administration as a maintenance therapy in a prolonged course, although viral clearance did not occur. Review of the literature highlighted a variety of pathological renal lesions associated with parvovirus B19 infection, although epidemiological data on parvovirus B19 infection in kidney transplant recipients, standardised diagnostic and therapeutic protocols, and the prospect for specific antiviral therapy are still scarce. Increased awareness of clinical relevance of parvovirus B19 infection in patients who have had a kidney transplant should direct future efforts towards better consideration and comprehension of viral-induced pathogenesis, aimed at effective diagnosis and appropriate therapy.