Gómez Natalia, Hayes Strella de la, Rozas Gabriela
Departamento de Anatomía Patológica, Hospital Barros Luco Trudeau, Santiago, Chile.
Departamento de Hematología, Hospital Barros Luco Trudeau, Santiago, Chile.
Rev Chilena Infectol. 2020 Dec;37(6):775-779. doi: 10.4067/S0716-10182020000600775.
Acute parvovirus B19 infection is a self-limiting disease in patients with normal immune response. However, in patients with blood dyscrasias, it is possible to present with an aplastic crisis. We present the case of a 48-year-old man who had developed an aplastic crisis as a result of an acute parvovirus B19 infection with an undiagnosed hereditary spherocytosis. Suspicions of the parvovirus infection began to arise after a routine bone marrow histopathological analysis which showed erythroblastic hyperplasia with giant erythroid precursor and viral inclusions. A subsequent immunohistochemical analysis tested positive for VP1 and VP2 capsid proteins of parvovirus B19 in infected cells. The diagnostic suspicion was later confirmed with the presence of anti-parvovirus B19 IgM. According to our review, this is the first published case in Latin America that documents an adult patient with normal immune response whose first symptom of hereditary spherocytosis was an aplastic crisis induced by an acute parvovirus B19 infection.
对于免疫反应正常的患者，急性B19微小病毒感染是一种自限性疾病。然而，对于血液系统疾病患者，可能会出现再生障碍危象。我们报告一例48岁男性病例，该患者因急性B19微小病毒感染并发未确诊的遗传性球形红细胞增多症而出现再生障碍危象。在常规骨髓组织病理学分析显示有幼红细胞增生、巨大红系前体细胞和病毒包涵体后，开始怀疑存在微小病毒感染。随后的免疫组织化学分析显示，感染细胞中B19微小病毒的VP1和VP2衣壳蛋白检测呈阳性。后来抗B19微小病毒IgM的出现证实了诊断怀疑。根据我们的综述，这是拉丁美洲首次发表的病例，记录了一名免疫反应正常的成年患者，其遗传性球形红细胞增多症的首发症状是由急性B19微小病毒感染诱发的再生障碍危象。
