[Aplastic crisis caused by Parvovirus B-19. Response to treatment with low doses of gammaglobulin].

BACKGROUND

Parvovirus B19 is the etiologic agent of transient aplastic crisis, an acute episode of bone marrow failure in persons with underlying hemolysis. Successful administration of gammaglobulin in some chronic cases and immunocompromised patients infected with parvovirus B-19, resulting in the elimination of this virus has been reported. However little is known about the evolution of acute aplastic crisis in treated patients with chronic hemolysis nor about the minimal effective dose of immunoglobulin.

METHODS

We report a family infected by Parvovirus B 19, discovered when a pure red blood-cell aplasia broke out in one family member who was suffering from a chronic haemolytic disease. The diagnosis was considered by presence of giant proerythroblasts in bone marrow and later confirmed by DNA viral detection using PCR technique.

RESULTS

The patient was treated with a small dose of polivalent intravenous gammaglobulin, with a temporary disappearance of the virus from his serum during treatment.

CONCLUSION

The usefulness, doses and length of immunoglobulin treatment in patients with transient aplastic crisis is discussed. Our results show that treatment with low doses of I.V. gammaglobulin able to control viremia and probably shorten the episode of anemia and acute aplastic crisis in this patient with chronic hemolytic anemia and parvovirus B-19 infection. This observation could be useful and cost saving also in chronic cases and in immunocompromised.