Skip to main content

Advertisement

SpringerLink
Log in

Acute Parvovirus B19 Infection Leading to Severe Aplastic Anemia in a Previously Healthy Adult Female

  • Case Report
  • Published:
Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

Human Parvovirus B19 has been linked to a variety of diseases. One of the most common complications is transient aplastic crisis in patients with chronic hemolytic anemia. Very few case reports have implicated this virus as a putative etiology behind hepatitis and severe aplastic anemia in immuno competent individuals. We report a case of severe aplastic anemia in a previously healthy adult female due to acute parvovirus B19 infection. Laboratory examination showed pancytopenia in peripheral blood and severe hypoplastic bone marrow on biopsy. Serological analysis (ELISA) revealed acute Parvovirus B19 infection. In the face of unavailable HLA matched bone marrow donor, immuno-supressive therapy was contemplated, but could not be given because of financial constraints. Pancytopenia persists till date, 4 months after the diagnosis, with the patient requiring repeated packed red cell and irradiated platelet transfusions. Thus, acute infection with this virus must be considered a cause of acquired aplastic anemia even in individuals without underlying disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Moore TL (2000) Parvovirus-associated arthritis. Curr Opin Rheumatol 12:289–294

    Article  PubMed  CAS  Google Scholar 

  2. Frickhofen N, Abkowitz JL, Safford M, Berry JM, Antunez-de-Mayolo J, Astrow A et al (1990) Persistent B19 parvovirus infection in patients infected with human immunodeficiency virus type 1 (HIV-1): a treatable cause of anemia in AIDS. Ann Intern Med 113:926–933

    PubMed  CAS  Google Scholar 

  3. Frickhofen N, Chen ZJ, Young NS, Cohen BJ, Heimpel H, Abkowitz JL (1994) Parvovirus B19 as a cause of acquired chronic pure red cell aplasia. Br J Haematol 87:818–824

    Article  PubMed  CAS  Google Scholar 

  4. Serjeant BE, Hambleton RR, Kerr S, Kilty CG, Serjeant GR (2004) Haematological response to parvovirus B19 infection in homozygous sickle-cell disease. Lancet 358:1779–1780

    Article  Google Scholar 

  5. Saunders PWG, Reid MM, Cohen BJ (1986) Human parvovirus induced cytopenias: a report of five cases. Br J Haematol 63:407–410

    Article  PubMed  CAS  Google Scholar 

  6. Osaki M, Matsubara K, Iwasaki T, Kurata T, Nigami H, Harigaya H et al (1999) Severe aplastic anemia associated with human parvovirus B19 infection in a patient without underlying disease. Ann Hematol 78:83–86

    Article  PubMed  CAS  Google Scholar 

  7. Quian XH, Zhang GC, Jiao XY, Zheng YJ, Cao YH, Xu DL et al (2002) Aplastic anemia associated with parvovirus B19 infection. Arch Dis Child 87:436–437

    Article  Google Scholar 

  8. Al-Abdwani RM, Khamis FA, Balkhair A, Sacharia M, Wali YA (2008) A child with human parvovirus B19 infection induced aplastic anemia and acute hepatitis: effectiveness of immunosuppressive therapy. Pediatr Hematol Oncol 25:699–703

    Article  PubMed  Google Scholar 

  9. Yetgin S, Cetin M, Ozyurek E, Aslan D, Uckan D (2004) Parvovirus b19 infection associated with severe aplastic anemia in an immunocompetent patient. Pediatr Hematol Oncol 21:223–226

    Article  PubMed  Google Scholar 

  10. Goto H, Ishida A, Fujii H, Kuroki F, Takahashi H, Ikuta K et al (2004) Successful bone marrow transplantation for severe aplastic anaemia in a patient with persistent human parvovirus B19 infection. Int J Hematol 79:384–386

    Article  PubMed  Google Scholar 

  11. Kaptan K, Beyan C, Ural AU, Ustün C, Cetin T, Avcu F et al (2001) Successful treatment of severe aplastic anemia associated with human parvovirus B19 and Epstein-Barr virus in a healthy subject with allo-BMT. Am J Hematol 67:252–255

    Article  PubMed  CAS  Google Scholar 

  12. Mishra B, Malhotra P, Ratho RK, Singh MP, Varma S, Varma N (2005) Human Parvovirus B19 in patients with aplastic anemia. Am J Hematol 79:166–167

    Article  PubMed  Google Scholar 

  13. Young NS, Brown KE (2004) Mechanisms of disease: Parvovirus B19. N Engl J Med 350:586–597

    Article  PubMed  CAS  Google Scholar 

  14. Risks associated with human parvovirus B19 infection (1989) MMWR Morb Mortal Wkly Rep 38:81–88; 93–97

    Google Scholar 

  15. Brown KE, Anderson SM, Young NS (1993) Erythrocyte P antigen: cellular receptor for B19 parvovirus. Science 262:114–117

    Article  PubMed  CAS  Google Scholar 

  16. Chisaka H, Morita E, Yaegashi N, Sugamura K (2003) Parvovirus B19 and the pathogenesis of anaemia. Rev Med Virol 13:347–359

    Article  PubMed  CAS  Google Scholar 

  17. Srivastava A, Bruno E, Briddell R, Cooper R, Srivastava C, Van Besien K et al (1990) Parvovirus B19-induced perturbation of human megakaryocytopoiesis in vitro. Blood 76:1997–2004

    PubMed  CAS  Google Scholar 

  18. Chen MY, Hung CC, Fang CT, Hsieh SM (2001) Reconstituted immunity against persistent parvovirus B19 infection in a patient with acquired immunodeficiency syndrome after highly active antiretroviral therapy. Clin Infect Dis 32:1361–1365

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

The authors thank Dr. Shashi Khare, Additional Director and Head (microbiology), National Centre for Disease Control, New Delhi, for kindly providing the details of ELISA kit used for detecting IgM Parvovirus B19 antibodies.

Author information

Authors and Affiliations

  1. Department of Medicine Unit VII and Endocrinology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India

    Rajesh Rajput

  2. Department of Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India

    Ashish Sehgal, Deepak Jain & Abhishek Gupta

  3. Department of Pathology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India

    Rajeev Sen

  4. 241, Sector-2, Rohtak, 124001, Haryana, India

    Rajesh Rajput

Authors
  1. Rajesh Rajput
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ashish Sehgal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Deepak Jain
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rajeev Sen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Abhishek Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rajesh Rajput.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rajput, R., Sehgal, A., Jain, D. et al. Acute Parvovirus B19 Infection Leading to Severe Aplastic Anemia in a Previously Healthy Adult Female. Indian J Hematol Blood Transfus 28, 123–126 (2012). https://doi.org/10.1007/s12288-011-0112-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12288-011-0112-0

Keywords

Search

Navigation