Rajput Rajesh, Sehgal Ashish, Jain Deepak, Sen Rajeev, Gupta Abhishek
Department of Medicine Unit VII and Endocrinology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana India ; 241, Sector-2, Rohtak, 124001 Haryana India.
Indian J Hematol Blood Transfus. 2012 Jun;28(2):123-6. doi: 10.1007/s12288-011-0112-0. Epub 2011 Sep 10.
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.
人类细小病毒B19与多种疾病有关。最常见的并发症之一是慢性溶血性贫血患者发生的短暂再生障碍危象。极少有病例报告表明该病毒是免疫功能正常个体肝炎和严重再生障碍性贫血的假定病因。我们报告一例既往健康的成年女性因急性细小病毒B19感染导致严重再生障碍性贫血的病例。实验室检查显示外周血全血细胞减少,活检显示骨髓严重增生低下。血清学分析(ELISA)显示急性细小病毒B19感染。由于缺乏人类白细胞抗原匹配的骨髓供体,考虑进行免疫抑制治疗,但因经济限制未能实施。诊断后4个月,全血细胞减少至今仍持续存在,患者需要反复输注浓缩红细胞和辐照血小板。因此,即使在没有基础疾病的个体中,也必须考虑这种病毒的急性感染是获得性再生障碍性贫血的一个病因。