Parvovirus B-19 Induced Anemia in a Heart Transplant Recipient: Report of a Pediatric Case and Brief Review of Literature.

Background

Parvovirus B19 (B19V) is normally a self-limiting infection in immunocompetent individuals but can cause severe, persistent anemia in immunocompromised patients, particularly in solid organ transplant (SOT) recipients. Patient: Retrospective review of the patient's clinical, laboratory, and pathology findings to describe the disease progression and management.

Results

The patient, a 3 y old girl, developed progressive anemia 15 months post-heart transplant. Bone marrow (BM) biopsy demonstrated B19V nuclear inclusions, and PCR confirmed viremia, consistent with erythroid aplastic crisis. Treatment with intravenous immunoglobulin (IVIG) led to hematologic improvement, but anemia and viral reactivation recurred after discontinuation. Her course was further complicated by Epstein-Barr virus (EBV)-associated post-transplant lymphoproliferative disorder (PTLD) and multi-organ dysfunction, resulting in death 34 months post-transplant.

Conclusions

This case represents one of the youngest documented pediatric heart transplant recipients with B19V induced anemia, complicated by viral reactivation despite IVIG, leading to a fatal outcome. Continued viral surveillance and individualized management are needed to improve outcomes in this vulnerable population.