Mediterranean Journal of Hematology and Infectious Diseases (Mar 2018)

Parvovirus B19-triggered acute hemolytic anemia and thrombocytopenia in a child with Evans syndrome

  • ELPIS MANTADAKIS

DOI
https://doi.org/10.4084/mjhid.2018.018
Journal volume & issue
Vol. 10, no. 1
pp. e2018018 – e2018018

Abstract

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Background: Human parvovirus B19 (HPV-B19) is the etiologic agent of erythema infectiosum, of transient aplastic crises in individuals with underlying chronic hemolytic disorders, and of chronic pure red cell aplasia in immunocompromised individuals. Case report. We describe a 14-year-old girl with long-standing Evans syndrome, who presented with severe anemia, reticulocytopenia and thromocytopenia. A bone marrow aspirate revealed severe erythroid hypoplasia along with presence of giant pronormoblasts, while serological studies and real-time PCR of whole blood were positive for acute parvovirus B19 infection. The patient was initially managed with corticosteroids, but both cytopenias resolved only after administration of intravenous gamma globulin 0.8g/kg. Conclusion: Acute parvovirus B19 infection should be suspected in patients with immunologic diseases, who present with reticulocytopenic hemolytic anemia and thrombocytopenia. In this setting, intravenous gamma globulin is effective for both cytopenias.

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