Article

An adult with aplastic crisis induced by human parvovirus B19 as an initial presentation of hereditary spherocytosis.

Department of Intemal Medicine, College of Medicine, Hallym University, Seoul, Korea.
The Korean Journal of Internal Medicine 04/2005; 20(1):96-9. pp.96-9
Source: PubMed

ABSTRACT The association between aplastic crisis and human parvovirus (HPV) B19 infection is well described in patients with sickle cell anemia. This association has also been described, although much less frequently, in patients with hereditary spherocytosis (HS). However, most cases of aplastic crises in patients with HS and induced by HPV B19 have been reported in children or adolescents. In this paper, we describe an aplastic crisis induced by HPV B19 in an adult with HS. A 34-year-old female presented with presyncope, febrile sensation, and myalgia. The complete blood counts showed severe anemia. The peripheral blood smear revealed spherocytosis with reticulocytopenia and pancytopenia. The direct Coombs' test was negative; the osmotic fragility test was positive. In the bone marrow aspirates, a few giant pronormoblasts with deep blue cytoplasm, pseudopods, and intracellular inclusion bodies were observed. The patient was given eight units of packed red blood cells. HPV B19 infection was proven by the presence of IgM antibodies to HPV B19 and the detection of viral DNA using the PCR technique. To the best of our knowledge, this is the first report in Korea that describes an adult with aplastic crisis presenting initially with HS.

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Keywords

34-year-old female
 
aplastic crises
 
aplastic crisis
 
aplastic crisis induced
 
blue cytoplasm
 
bone marrow aspirates
 
complete blood counts
 
febrile sensation
 
first report
 
HPV B19 infection
 
human parvovirus
 
IgM antibodies
 
intracellular inclusion bodies
 
osmotic fragility test
 
PCR technique
 
peripheral blood smear
 
red blood cells
 
severe anemia
 
sickle cell anemia
 
viral DNA