Sharada Raju Rane, Nalini Vinayak Kadgi, Madhusudan Bapat Vishnuprasad, Preeti Balkisanji Agrawal, Shaila Chandrakant Puranik
Department of Pathology, Byramjee Jeejeebhoy Government Medical College, A-7, Devi chambers, 23/5 A, Bund Garden Road, Pune, 411001 Maharashtra India.
Department of Pathology, Byramjee Jeejeebhoy Government Medical College, B/403, Nancy Lake Homes, Opposite Bharati Vidyapeeth, Pune-Satara Road, Katraj, Pune, 411046 Maharashtra India.
Indian J Hematol Blood Transfus. 2014 Sep;30(Suppl 1):133-4. doi: 10.1007/s12288-013-0287-7. Epub 2013 Sep 26.
Human parvovirus B19 is highly tropic to human bone marrow and replicates only in erythroid progenitor cells. It is causative agent of transient aplastic crisis in patients with chronic haemolytic anemia. In immunocompromised patients persistent parvovirus B19 infection may develop and it manifests as pure red cell aplasia and chronic anaemia. Bone marrow is characterised morphologically by giant pronormoblast stage with little or no further maturation. We encountered a case of 6 year old HIV positive male child presented with pure red cell aplasia due to parvovirus B19 infection. Bone marrow aspiration cytology revealed giant pronormoblast with prominent intranuclear inclusions led to suspicion of parvovirus B19 infection which was confirmed by DNA PCR. This case is presented to report classical morphological features of parvovirus B19 infection rarely seen on bone marrow examination should warrant the suspicion of human parvovirus B19 infection in the setting of HIV positive patient with repeated transfusions and confirmation should be done by PCR.
人细小病毒B19对人骨髓具有高度嗜性,仅在红系祖细胞中复制。它是慢性溶血性贫血患者发生短暂再生障碍危象的病原体。在免疫功能低下的患者中,可能会发生持续性细小病毒B19感染,表现为纯红细胞再生障碍和慢性贫血。骨髓在形态学上的特征是巨大原幼红细胞阶段,几乎没有或没有进一步成熟。我们遇到一例6岁HIV阳性男童,因细小病毒B19感染出现纯红细胞再生障碍。骨髓穿刺细胞学检查发现巨大原幼红细胞,核内包涵体明显,怀疑为细小病毒B19感染,DNA PCR证实了这一诊断。本文报告该病例,以说明细小病毒B19感染的典型形态学特征,在骨髓检查中很少见,在反复输血的HIV阳性患者中应怀疑人细小病毒B19感染,并通过PCR进行确诊。