, Volume 96, Issue 6, pp 820-821

Severe bone marrow failure associated with human parvovirus B19 infection in a case with no underlying disorder

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Human parvovirus B19 (B19) is known to induce erythema infectiosum. B19 mainly attacks the erythroid progenitor cells of the bone marrow and arrests their proliferation [1], but generally these alterations improve spontaneously within a short period. We report a previously healthy boy with persistent severe bone marrow aplasia associated with B19 infection.

A 14-year-old boy complaining of fever and purpura was referred to our hospital. He had been healthy with no history of hemolytic disorders and no recent episodes of medication use. The pyrexia had commenced 3 days prior to the referral, and purpura appeared in his legs and arms 2 days before. The white blood cell (WBC) count was low (1.84 × 109/L; neutrophils 0.47 × 109/L); this was accompanied with reticulocytopenia (9.2 × 109/L) and thrombocytopenia (12.0 × 109/L).

A bone marrow examination performed on day 1 of hospitalization revealed marked hypoplasia (nuclear cell count 4.0 × 109/L, Fig. 1a) complicated with neither dysplasia n