• M Mäske, M Haubitz, S Graf, G Köhler, P Kostrewa, and P Benöhr.
• Medizinische Klinik III, Klinikum Fulda, Universitätsmedizin Marburg - Campus Fulda, Pacelliallee 4, 36043, Fulda, Deutschland. Michele.Maeske@klinikum-fulda.de.
• Internist (Berl). 2021 Mar 1; 62 (3): 320-325.

AbstractAn allogeneic kidney transplantation (match 1‑1‑0, cytomegalovirus, CMV, donor, D, +/recipient, R, - high risk) was performed in a 36-year-old patient. The patient was on dialysis due to a tubulointerstitial nephritis confirmed by biopsy 11 years previously. Posttransplantation there was a gradual decrease in the hemoglobin (Hb) level from 11.4 g/dl to 7.3 g/dl during the initial hospitalization period. Initially this was explained by the kidney transplantation and chronic fibrosing antral gastritis with erosions. Despite repeated transfusion of red cell concentrates, a refractory anemia persisted, which is why the patient presented several times at our clinic for further diagnosis and treatment. The presence of giant erythroblasts in the bone marrow and quantitative detection of parvovirus B19 (>900 million IU/ml DNA replications) was consistent with a virus-associated red cell aplasia. Intravenous immunoglobulin administration was established and showed long-term therapeutic success.

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