Rare case of Pure Red Cell Aplasia (PRCA) in a post kidney transplant recipient (KTR) A case report

Anemia is a frequent problem in kidney transplant recipient. Severe erythropoietin resistant anemia caused by acquired pure red cell aplasia (PRCA) is rare. Parvovirus B- 19 is most commonly associated with severe anemia. In this report, we describe the occurrence of PV B-19 negative acquired PRCA in renal allograft recipient. A 37 year old KTR of renal transplantation vintage of 14 years, presented to us with rapid onset anemia (Hb-5gmdl) requiring multiple blood transfusions. On evaluation he had erythropoietin resistant anemia with marked reticulocytopenia, normal total leukocyte and platelet count, no hemolysis and moderately hypocellular marrow with marked erythroid hypoplasia consistent with pure red cell aplasia (PRCA). His parvovirus IgM antibodies were negative. After a failed trial of oral steroids and IV immunoglobulin he was treated with oral stanazol with which he improved though with a delayed response over 6 months with no recurrence till the last follow-up visit.