一名成人以人细小病毒B19诱发的再生障碍危象为遗传性球形红细胞增多症的首发表现。
An adult with aplastic crisis induced by human parvovirus B19 as an initial presentation of hereditary spherocytosis.
作者信息
Oh Sook Eui, Kim Jung Han, Choi Chi Hun, Park Kwang Hyuk, Jung Joo Young, Park Young lee, Park Min-Jeong
机构信息
Department of Intemal Medicine, College of Medicine, Hallym University, Seoul, Korea.
出版信息
Korean J Intern Med. 2005 Mar;20(1):96-9. doi: 10.3904/kjim.2005.20.1.96.
The association between aplastic crisis and human parvovirus (HPV) B19 infection is well described in patients with sickle cell anemia. This association has also been described, although much less frequently, in patients with hereditary spherocytosis (HS). However, most cases of aplastic crises in patients with HS and induced by HPV B19 have been reported in children or adolescents. In this paper, we describe an aplastic crisis induced by HPV B19 in an adult with HS. A 34-year-old female presented with presyncope, febrile sensation, and myalgia. The complete blood counts showed severe anemia. The peripheral blood smear revealed spherocytosis with reticulocytopenia and pancytopenia. The direct Coombs' test was negative; the osmotic fragility test was positive. In the bone marrow aspirates, a few giant pronormoblasts with deep blue cytoplasm, pseudopods, and intracellular inclusion bodies were observed. The patient was given eight units of packed red blood cells. HPV B19 infection was proven by the presence of IgM antibodies to HPV B19 and the detection of viral DNA using the PCR technique. To the best of our knowledge, this is the first report in Korea that describes an adult with aplastic crisis presenting initially with HS.
再生障碍性危象与人类细小病毒(HPV)B19感染之间的关联在镰状细胞贫血患者中已有详尽描述。这种关联在遗传性球形红细胞增多症(HS)患者中也有报道,尽管频率要低得多。然而,大多数由HPV B19诱发的HS患者再生障碍性危象病例都报道于儿童或青少年。在本文中,我们描述了一名成年HS患者由HPV B19诱发的再生障碍性危象。一名34岁女性出现晕厥前症状、发热感和肌痛。全血细胞计数显示严重贫血。外周血涂片显示球形红细胞增多,伴有网织红细胞减少和全血细胞减少。直接抗人球蛋白试验阴性;渗透脆性试验阳性。在骨髓穿刺物中,观察到一些具有深蓝色细胞质、伪足和细胞内包涵体的巨大早幼红细胞。该患者接受了8单位的浓缩红细胞。通过检测HPV B19的IgM抗体以及使用PCR技术检测病毒DNA,证实了HPV B19感染。据我们所知,这是韩国首例描述成年HS患者最初出现再生障碍性危象的报告。