부산대학교 도서관

Human parvovirus B19, now classified as "Erythrovirus", is known as the etiologic agent of aplastic crisis in patients with red cell defects. We describe a 16 year old patient from West-Africa who, until recently, was considered healthy. When he developed flu like symptoms including fever and arthralgia, together with a maculopapular rash and lymphadenopathy, he was admitted to the hospital for further investigation. Laboratory findings revealed a severe, normochromic anemia (Hb 6.0 g/dl), thrombocytopenia (86.0 G/l) and leucocytosis (29.8 G/l). To rule out a leukemic process a bone morrow biopsy was performed. The results showed normal megakaryo- and granulocytopoiesis, but a differentiation arrest in erythropoiesis with giant proerythroblasts and lack of macroblasts and normoblasts. Reticulocytes in peripheral blood amounted to less than 0.01%. The patient received two red cell concentrates, antibiotics and NSAID as supportive treatment. However, no immediate improvement of the anemia could be seen and it took several weeks until the symptoms gradually resolved. Virological tests had disclosed a parvovirus infection with specific anti-B 19-IgM and IgG antibodies. Further hematological examinations, including hemoglobin electrophoresis, revealed as underlining red cell disorder Hb SC disease. Our observation underlines the necessity of careful diagnostic procedures in patients which present with acute anemia and signs of viral infection. [ABSTRACT FROM AUTHOR]