Yetgin S, Cetin M, Yenicesu I, Ozaltin F, Uçkan D
Department of Pediatric Hematology, Ihsan Doĝramaci Children's Hospital, Hacettepe University, Ankara, Turkey.
Eur J Haematol. 2000 Oct;65(4):276-8. doi: 10.1034/j.1600-0609.2000.065004276.x.
An 11-month-old patient with parvovirus infection mimicking juvenile myelomonocytic leukemia (JMML) is presented. The patient's history, presenting physical and laboratory features, was suggestive of JMML and consisted of fever, hepatosplenomegaly, lymphadenopathy, desquamation of the skin, anemia, leukocytosis with monocytosis and trilineage dysplastic findings of the peripheral blood and bone marrow. However, positive IgM titers for parvovirus B19 followed by seroconversion, negative cytogenetics and the benign follow-up of the patient suggested acute parvovirus infection as an etiologic factor for development of dysplastic features in the patient, and thus is recommended for consideration in the differential diagnosis of MDS. Although parvovirus B19 infection mimicking MDS has previously been shown in two patients with spherocytosis and one with subclinical immune deficiency; to our knowledge, the present report is the first describing the association of acute parvovirus B19 infection with dysplastic features mimicking myelodysplasia (MDS) in a child without a demonstrable underlying hematolymphoid disorder.
本文报告了一名11个月大的细小病毒感染患者，其临床表现酷似青少年型骨髓单核细胞白血病（JMML）。患者的病史、体格检查和实验室检查结果提示为JMML，包括发热、肝脾肿大、淋巴结病、皮肤脱屑、贫血、白细胞增多伴单核细胞增多以及外周血和骨髓的三系发育异常表现。然而，细小病毒B19 IgM滴度阳性随后发生血清转化、细胞遗传学检查阴性以及患者的良性随访结果提示，急性细小病毒感染是导致患者发育异常特征的病因，因此在骨髓增生异常综合征（MDS）的鉴别诊断中应考虑这一因素。尽管之前已有两例球形红细胞增多症患者和一例亚临床免疫缺陷患者出现了类似MDS的细小病毒B19感染；据我们所知，本报告是首例描述在无明显潜在血液淋巴系统疾病的儿童中，急性细小病毒B19感染与类似骨髓增生异常（MDS）的发育异常特征之间的关联。
