Osaki M, Matsubara K, Iwasaki T, Kurata T, Nigami H, Harigaya H, Baba K
Department of Pediatrics, Nishi-Kobe Medical Center, Japan.
Ann Hematol. 1999 Feb;78(2):83-6. doi: 10.1007/s002770050477.
Human parvovirus B19 (B19 virus) infection is known to induce aplastic crisis in patients with hemolytic anemia. In healthy subjects, B19 infection may sometimes cause mild pancytopenia, but these changes are transient and recovery is spontaneous. We report the first case of aplastic anemia in a previously healthy boy without any underlying diseases, following asymptomatic infection with the B19 virus. Laboratory examination initially showed thrombocytopenia, mild leukopenia in the peripheral blood, and severe hypoplastic bone marrow. Since pancytopenia developed and worsened progressively, immunosuppressive therapy was given, resulting in a complete remission. Despite the lack of an infectious prodrome, serological and histological analysis revealed an underlying infection with the B19 virus. Thus, B19 virus infection must be considered one of the causes of aplastic anemia in patients without underlying hemolytic anemia and an apparent episode of the viral infection.
已知人类细小病毒B19(B19病毒)感染可诱发溶血性贫血患者发生再生障碍危象。在健康受试者中,B19感染有时可能导致轻度全血细胞减少,但这些变化是短暂的,且可自发恢复。我们报告了首例既往健康、无任何基础疾病的男孩在无症状感染B19病毒后发生再生障碍性贫血的病例。实验室检查最初显示外周血血小板减少、轻度白细胞减少以及严重的骨髓造血功能低下。由于全血细胞减少逐渐发展并恶化,遂给予免疫抑制治疗,结果实现了完全缓解。尽管缺乏感染前驱症状,但血清学和组织学分析显示存在B19病毒的潜在感染。因此,对于无基础溶血性贫血且无明显病毒感染发作的再生障碍性贫血患者,必须将B19病毒感染视为病因之一。