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Case Report Open Access

Parvovirus B19‑associated erythropoiesis‑stimulating agent hyporesponsiveness in a patient on maintenance hemodialysis: A case report

  • Authors:
    • Theodoros Eleftheriadis
    • Maria Divani
    • Maria-Anna Polyzou-Κonsta
    • Evangelos Lykotsetas
    • Christina Poulianiti
    • Andriani Balatsouka
    • Ioannis Stefanidis
  • View Affiliations / Copyright

    Affiliations: Department of Nephrology, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
    Copyright: © Eleftheriadis et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 53
    |
    Published online on: August 24, 2026
       https://doi.org/10.3892/mi.2026.337
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Abstract

Parvovirus B19 is an uncommon cause of hypoproliferative anemia. In maintenance hemodialysis (HD), anemia is rarely explained by a single mechanism, and the viral suppression of erythropoiesis may be overlooked when infection, inflammation and iron deficiency occur concomitantly. The present case report describes the case of a 79‑year‑old man receiving chronic HD who was admitted twice with prolonged fever and was eventually treated for culture‑negative mitral valve endocarditis. During the second hospitalization period, the hemoglobin level decreased from 8.8 to 7.7 g/dl, despite an increase in the level of recombinant human erythropoietin (rHuEPO) from 30,000 to 60,000 IU/week. The number of reticulocytes decreased from 2.07 to 0.95%, and a blood transfusion was required. The patient tested positive for Parvovirus B19 immunoglobulin M and immunoglobulin G, and polymerase chain reaction (PCR) confirmed active infection. Bleeding, hemolysis, vitamin B12 and folate deficiency, uncontrolled hypothyroidism, malignancy and inadequate dialysis were excluded. Intravenous immunoglobulin was administered at 0.4 g/kg/day for 5 days. By the time of discharge, the hemoglobin level had increased to 9.4 g/dl and reticulocytes had increased to 2.7%. Repeat PCR at follow‑up, 20 days following discharge, yielded negative results. Severe iron deficiency was then evident, and following the administration of ferric carboxymaltose, the hemoglobin level further increased to 12.1 g/dl, allowing a reduction in rHuEPO. On the whole, the present case report underlines that Parvovirus B19, although rare, should remain in the differential diagnosis of erythropoiesis‑stimulating agent‑resistant anemia in patients undergoing HD.
View Figures

Figure 1

18F-FDG PET/CT images. (A) Axial chest
image demonstrating hypermetabolic hilar/mediastinal lymph nodes
associated with diffuse infiltrative-type pulmonary 18F-FDG uptake.
(B) Axial upper abdominal image demonstrating diffusely increased
splenic 18F-FDG uptake. 18F-FDG, axial fused fluorodeoxyglucose F
18.

Figure 2

Simplified clinical course of
Parvovirus B19-associated anemia in a patient on maintenance
hemodialysis. Boxes summarize Hb (g/dl), Ret (%), CRP (mg/dl),
ferritin (ng/ml), TSAT (%), Parvovirus B19 serology and PCR
results, rHuEPO dose, IVIG administration, blood transfusion and
follow-up findings. Hb, hemoglobin; Ret, reticulocytes; CRP,
C-reactive protein; TSAT, transferrin saturation; PCR, polymerase
chain reaction; rHuEPO, recombinant human erythropoietin; IVIG,
intravenous immunoglobulin.`
View References

1 

Mikhail A, Brown C, Williams JA, Mathrani V, Shrivastava R, Evans J, Isaac H and Bhandari S: Renal association clinical practice guideline on Anaemia of chronic kidney disease. BMC Nephrol. 18(345)2017.PubMed/NCBI View Article : Google Scholar

2 

Babitt JL, Eisenga MF, Haase VH, Kshirsagar AV, Levin A, Locatelli F, Małyszko J, Swinkels DW, Tarng DC, Cheung M, et al: Controversies in optimal anemia management: conclusions from a kidney disease: Improving global outcomes (KDIGO) conference. Kidney Int. 99:1280–1295. 2021.PubMed/NCBI View Article : Google Scholar

3 

Young NS and Brown KE: Parvovirus B19. N Engl J Med. 350:586–597. 2004.PubMed/NCBI View Article : Google Scholar

4 

Duranay M, Bali M, Sahin M, Yakinci G, Vurgun N and Dilmen U: Parvovirus B19 infection and unresponsiveness to erythropoietin therapy in Haemodialysis patients. Nephrol Dial Transplant. 13:779–780. 1998.PubMed/NCBI View Article : Google Scholar

5 

Ozeki M, Fukushima T, Ohzeki M, Sasaki T and Kashihara N: A nosocomial parvovirus B19 infection-induced transient aplastic crisis in a patient with chronic renal failure. Clin Nephrol. 65:141–143. 2006.PubMed/NCBI View Article : Google Scholar

6 

Shi Y, Shi X, Wang H, Zhou Z, Zhang L and Chen L: Pure red cell aplasia secondary to parvovirus B19 infection as a rare cause of anemia in a dialysis patient. Intern Med. 63:2647–2650. 2024.PubMed/NCBI View Article : Google Scholar

7 

Evangelista L, Panunzio A, Polverosi R, Ferretti A, Chondrogiannis S, Pomerri F, Rubello D and Muzzio PC: Early bone marrow metastasis detection: The additional value of FDG-PET/CT vs. CT imaging. Biomed Pharmacother. 66:448–453. 2012.PubMed/NCBI View Article : Google Scholar

8 

Kitajima K, Yamamoto S, Fukushima K, Yamakado K, Katsuura T, Igarashi Y, Kawanaka Y, Mouri M and Hirota S: FDG-PET/CT as a post-treatment restaging tool in urothelial carcinoma: Comparison with contrast-enhanced CT. Eur J Radiol. 85:593–598. 2016.PubMed/NCBI View Article : Google Scholar

9 

Guillen E, Hermida E, Rodas L, Broseta JJ and Cases A: Aplastic crisis secondary to parvovirus B19 primoinfection as an infrequent cause of anemia in an immunocompetent, non-dialysis chronic kidney disease patient. Clin Nephrol. 95:224–226. 2021.PubMed/NCBI View Article : Google Scholar

10 

Schröder C, Roeles J, Schwarzer A, Heuser M, Retzlaff J and Hiß M: Treatment-refractory anaemia in a 35-year-old heart transplant recipient on chronic hemodialysis. Internist (Berl). 62:768–771. 2021.PubMed/NCBI View Article : Google Scholar

11 

Eleftheriadis T, Antoniadi G, Liakopoulos V, Kartsios C and Stefanidis I: Basic science and dialysis: Disturbances of acquired immunity in hemodialysis patients. Semin Dial. 20:440–451. 2007.PubMed/NCBI View Article : Google Scholar

12 

Broliden K, Tolfvenstam T and Norbeck O: Clinical aspects of parvovirus B19 infection. J Intern Med. 260:285–304. 2006.PubMed/NCBI View Article : Google Scholar

13 

Landry ML: Parvovirus B19. Microbiol Spectr. 4(DMIH2-0008-2015)2016.PubMed/NCBI View Article : Google Scholar

14 

Maple PAC, Hedman L, Dhanilall P, Kantola K, Nurmi V, Söderlund-Venermo M, Brown KE and Hedman K: Identification of past and recent parvovirus B19 infection in immunocompetent individuals by quantitative PCR and enzyme immunoassays: A dual-laboratory study. J Clin Microbiol. 52:947–956. 2014.PubMed/NCBI View Article : Google Scholar

15 

Eleftheriadis T, Divani M, Leontaridis T, Poulianiti C, Polyzou-Konsta MA, Lykotsetas E and Stefanidis I: Parvovirus B19-induced pure red cell aplasia several years after kidney transplantation and following a transition from everolimus to tacrolimus. Exp Clin Transplant. 23:67–71. 2025.PubMed/NCBI View Article : Google Scholar

16 

Eid AJ and Ardura MI: AST Infectious Diseases Community of Practice. Human parvovirus B19 in solid organ transplantation: Guidelines from the American society of transplantation infectious diseases community of practice. Clin Transplant. 33(e13535)2019.PubMed/NCBI View Article : Google Scholar

17 

Kidney Disease; Improving Global Outcomes (KDIGO) Anemia Work Group. KDIGO 2026 clinical practice guideline for the management of anemia in chronic kidney disease (CKD). Kidney Int. 109:S1–S99. 2026.PubMed/NCBI View Article : Google Scholar

18 

Karaboyas A, Morgenstern H, Fleischer NL, Vanholder RC, Dhalwani NN, Schaeffner E, Schaubel DE, Akizawa T, James G, Sinsakul MV, et al: Inflammation and erythropoiesis-stimulating agent response in hemodialysis patients: A self-matched longitudinal study of anemia management in the dialysis outcomes and practice patterns study (DOPPS). Kidney Med. 2:286–296. 2020.PubMed/NCBI View Article : Google Scholar

19 

Crabol Y, Terrier B, Rozenberg F, Pestre V, Legendre C, Hermine O, Montagnier-Petrissans C, Guillevin L and Mouthon L: Groupe d'experts de l'Assistance Publique-Hôpitaux de Paris. Intravenous immunoglobulin therapy for pure red cell aplasia related to human parvovirus B19 infection: A retrospective study of 10 patients and review of the literature. Clin Infect Dis. 56:968–977. 2013.PubMed/NCBI View Article : Google Scholar

20 

Verhelst D, Rossert J, Casadevall N, Krüger A, Eckardt KU and Macdougall IC: Treatment of erythropoietin-induced pure red cell aplasia: A retrospective study. Lancet. 363:1768–1771. 2004.PubMed/NCBI View Article : Google Scholar

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Copy and paste a formatted citation
Spandidos Publications style
Eleftheriadis T, Divani M, Polyzou-Κonsta M, Lykotsetas E, Poulianiti C, Balatsouka A and Stefanidis I: Parvovirus B19‑associated erythropoiesis‑stimulating agent hyporesponsiveness in a patient on maintenance hemodialysis: A case report. Med Int 6: 53, 2026.
APA
Eleftheriadis, T., Divani, M., Polyzou-Κonsta, M., Lykotsetas, E., Poulianiti, C., Balatsouka, A., & Stefanidis, I. (2026). Parvovirus B19‑associated erythropoiesis‑stimulating agent hyporesponsiveness in a patient on maintenance hemodialysis: A case report. Medicine International, 6, 53. https://doi.org/10.3892/mi.2026.337
MLA
Eleftheriadis, T., Divani, M., Polyzou-Κonsta, M., Lykotsetas, E., Poulianiti, C., Balatsouka, A., Stefanidis, I."Parvovirus B19‑associated erythropoiesis‑stimulating agent hyporesponsiveness in a patient on maintenance hemodialysis: A case report". Medicine International 6.5 (2026): 53.
Chicago
Eleftheriadis, T., Divani, M., Polyzou-Κonsta, M., Lykotsetas, E., Poulianiti, C., Balatsouka, A., Stefanidis, I."Parvovirus B19‑associated erythropoiesis‑stimulating agent hyporesponsiveness in a patient on maintenance hemodialysis: A case report". Medicine International 6, no. 5 (2026): 53. https://doi.org/10.3892/mi.2026.337
Copy and paste a formatted citation
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Spandidos Publications style
Eleftheriadis T, Divani M, Polyzou-Κonsta M, Lykotsetas E, Poulianiti C, Balatsouka A and Stefanidis I: Parvovirus B19‑associated erythropoiesis‑stimulating agent hyporesponsiveness in a patient on maintenance hemodialysis: A case report. Med Int 6: 53, 2026.
APA
Eleftheriadis, T., Divani, M., Polyzou-Κonsta, M., Lykotsetas, E., Poulianiti, C., Balatsouka, A., & Stefanidis, I. (2026). Parvovirus B19‑associated erythropoiesis‑stimulating agent hyporesponsiveness in a patient on maintenance hemodialysis: A case report. Medicine International, 6, 53. https://doi.org/10.3892/mi.2026.337
MLA
Eleftheriadis, T., Divani, M., Polyzou-Κonsta, M., Lykotsetas, E., Poulianiti, C., Balatsouka, A., Stefanidis, I."Parvovirus B19‑associated erythropoiesis‑stimulating agent hyporesponsiveness in a patient on maintenance hemodialysis: A case report". Medicine International 6.5 (2026): 53.
Chicago
Eleftheriadis, T., Divani, M., Polyzou-Κonsta, M., Lykotsetas, E., Poulianiti, C., Balatsouka, A., Stefanidis, I."Parvovirus B19‑associated erythropoiesis‑stimulating agent hyporesponsiveness in a patient on maintenance hemodialysis: A case report". Medicine International 6, no. 5 (2026): 53. https://doi.org/10.3892/mi.2026.337
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