Transplant types affected:
(1) renal
(2) liver
(3) stem cell
(4) heart/lung
Onset is usually within the first 3 months after the transplant but may be delayed.
Clinical findings:
(1) fever
(2) flu-like symptoms
(3) weakness
(4) pneumonitis, with dyspnea
(5) hepatitis
(6) myocarditis, which may progress to cardiogenic shock
(7) thrombotic microangiopathy
(8) unexplained allograft dysfunction or loss
(9) skin rash
(10) arthralgias
(11) rarely a collapsing glomerulopathy
Laboratory findings:
(1) unexplained, refractory anemia (in almost 99%)
(2) occasionally leukopenia
(3) occasionally thrombocytopenia
Diagnostic tests (all 3 should be performed):
(1) serologic testing for IgM and IgG
(2) polymerase chain reaction (PCR)
(3) bone marrow examination (shows pure red cell aplasia and changes in pronormoblasts)
