International Journal of Hematology

, Volume 88, Issue 3, pp 336–340 | Cite as

Successful treatment of parainfluenza virus 3 pneumonia with oral ribavirin and methylprednisolone in a bone marrow transplant recipient

  • Takahiro ShimaEmail author
  • Goichi Yoshimoto
  • Atsushi Nonami
  • Shuro Yoshida
  • Kenjiro Kamezaki
  • Hiromi Iwasaki
  • Katsuto Takenaka
  • Toshihiro Miyamoto
  • Naoki Harada
  • Takanori Teshima
  • Koichi Akashi
  • Koji Nagafuji
Case Report


We report a case of severe parainfluenza (PIV) 3 pneumonia in a hematopoietic stem cell transplant recipient that was successfully treated with oral ribavirin and methylprednisolone. A 42-year-old woman diagnosed with acute myelogenous leukemia (FAB M5a) in first complete remission underwent allogeneic bone marrow transplantation from an HLA-matched unrelated donor in May 2006. In July 2007, she developed PIV3 pneumonia. Her respiratory status progressively worsened and she required O2 inhalation at 6 L/min. After an informed consent was obtained, oral ribavirin was initiated (16 mg/kg per day) for 1 week on July 31. By day 3 of treatment, the high-grade fever had disappeared. However, it recurred after ribavirin was discontinued. In addition, the patient’s hypoxia continued to worsen, requiring O2 inhalation at 9 L/min. To suppress the inflammatory reaction in the lung caused by PIV3 pneumonia, intravenous methylprednisolone (1,000 mg once a day for 3 days) was started along with high-dose oral ribavirin (16 mg/kg per day) on August 11. The patient showed dramatic clinical improvement, and oxygen inhalation was discontinued on September 3. Our case suggests that with concomitant effective anti-viral treatment, corticosteroids may suppress host inflammatory or immune reactions that lead to respiratory failure.


Ribavirin Parainfluenza virus Pneumonia Bone marrow transplantation 



We thank Dr. Takahiro Fukuda (National Cancer Center Hospital, Tokyo, Japan) for his valuable suggestions.


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Copyright information

© The Japanese Society of Hematology 2008

Authors and Affiliations

  • Takahiro Shima
    • 1
    Email author
  • Goichi Yoshimoto
    • 2
  • Atsushi Nonami
    • 1
  • Shuro Yoshida
    • 1
  • Kenjiro Kamezaki
    • 1
  • Hiromi Iwasaki
    • 2
  • Katsuto Takenaka
    • 1
  • Toshihiro Miyamoto
    • 2
  • Naoki Harada
    • 1
  • Takanori Teshima
    • 2
  • Koichi Akashi
    • 1
  • Koji Nagafuji
    • 1
  1. 1.Medicine and Biosystemic ScienceKyushu University Graduate School of Medical SciencesFukuokaJapan
  2. 2.Center for Cellular and Molecular MedicineKyushu University Graduate School of Medical SciencesFukuokaJapan

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