scholarly journals Parvovirus B19-triggered acute hemolytic anemia and thrombocytopenia in a child with Evans syndrome

2018 ◽  
Vol 10 (1) ◽  
pp. e2018018 ◽  
Author(s):  
ELPIS MANTADAKIS
Keyword(s):  
Hemolytic Anemia ◽  
Gamma Globulin ◽  
Parvovirus B19 ◽  
Pure Red Cell Aplasia ◽  
Etiologic Agent ◽  
Evans Syndrome ◽  
Erythema Infectiosum ◽  
Parvovirus B19 Infection ◽  
Intravenous Gamma Globulin ◽  
Immunologic Diseases

Background: Human parvovirus B19 (HPV-B19) is the etiologic agent of erythema infectiosum, of transient aplastic crises in individuals with underlying chronic hemolytic disorders, and of chronic pure red cell aplasia in immunocompromised individuals.Case report. We describe a 14-year-old girl with long-standing Evans syndrome, who presented with severe anemia, reticulocytopenia and thromocytopenia. A bone marrow aspirate revealed severe erythroid hypoplasia along with presence of giant pronormoblasts, while serological studies and real-time PCR of whole blood were positive for acute parvovirus B19 infection. The patient was initially managed with corticosteroids, but both cytopenias resolved only after administration of intravenous gamma globulin 0.8g/kg.Conclusion: Acute parvovirus B19 infection should be suspected in patients with immunologic diseases, who present with reticulocytopenic hemolytic anemia and thrombocytopenia. In this setting, intravenous gamma globulin is effective for both cytopenias.

Infection Control Measures for Human Parvovirus Bl9 in the Hospital Setting

1989 ◽  
Vol 10 (7) ◽  
pp. 326-329 ◽  
Author(s):  
Stanley J. Naides
Keyword(s):  
Parvovirus B19 ◽  
Hospital Setting ◽  
Personal Communication ◽  
Etiologic Agent ◽  
Control Measures ◽  
Erythema Infectiosum ◽  
Infection Control Measures ◽  
Parvovirus B19 Infection ◽  
Transient Aplastic Crisis ◽  
Fifth Disease

A human parvovirus was first discovered serendipitously in blood from asymptomatic donors in 1975' and designated B19 because of the location of the original positive serum in a test panel. Subsequently, the newly discovered virus was determined to be the etiologic agent of most cases of transient aplastic crisis in the setting of chronic hemolytic anemia and of the childhood exanthem erythema infectiosum, or fifth disease. While erythema infectiosum with its classic “slapped-cheek” rash is a childhood illness, “fifth disease” in the adult should not be overlooked. At least 40% of adults lack serological evidence of past human parvovirus B19 infection and are at risk. Adults tend to have a more subtle rash, often lacking the “slapped cheeks,” and tend to have a more severe constitutional, flu-like illness with prominent joint symptoms. While the arthralgia and arthritis of adult “fifth disease” are often self-limiting, they may become chronic and lead to an arthropathy that meets American College of Kheumatology criteria for a diagnosis of rheumatoid arthritis. The arthropathy has been reported to persist up to five years, the longest follow-up now available (A. Wolf; MD, personal communication, August 27, 1987).

Pure red cell aplasia due to parvovirus B19 in a patient treated with rituximab

Blood ◽  
2000 ◽  
Vol 96 (3) ◽  
pp. 1184-1186 ◽  
Author(s):  
Vivek R. Sharma ◽  
Donald R. Fleming ◽  
Stephen P. Slone
Keyword(s):  
Monoclonal Antibody ◽  
B Lymphocytes ◽  
Parvovirus B19 ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Humoral Immune ◽  
Red Cell Aplasia ◽  
Point Of Interest ◽  
Humoral Immune System ◽  
Parvovirus B19 Infection

Abstract Rituximab is a chimeric monoclonal antibody directed against CD20 and used in the treatment of B-cell non-Hodgkin's lymphoma. Due to its ability to deplete B lymphocytes, rituximab can interfere with humoral immunity, causing it to be suppressed for several months after treatment. The reported case depicts a serious consequence of this effect of rituximab therapy: pure red cell aplasia resulting from chronic parvovirus B19 infection. The point of interest in this case is not only the association between rituximab therapy and pure red cell aplasia, but the diagnostic and therapeutic utility of the knowledge of parvovirus B19 as the likely etiologic link between the two. Given the known efficacy of intravenous immunoglobulin (IVIg) in the treatment of chronic parvovirus B19 infection, this therapy can cure some of these patients and successfully render most others transfusion-independent until recovery of their own humoral immune system.

Occupational Risk of Human Parvovirus B19 Infection for School and Day-Care Personnel during an Outbreak of Erythema Infectiosum

1990 ◽  
Vol 45 (11) ◽  
pp. 755
Author(s):  
SHEILA M. GILLESPIE ◽  
MATTHEW L. CARTTER ◽  
STEVEN ASCH ◽  
JAMES B. ROKOS ◽  
G. WILLIAM GARY ◽  
...  
Keyword(s):  
Day Care ◽  
Parvovirus B19 ◽  
Occupational Risk ◽  
Human Parvovirus B19 ◽  
Erythema Infectiosum ◽  
Parvovirus B19 Infection

Double hit: Evans syndrome after malignant thymoma treatment and parvovirus B19 infection

2020 ◽  
Vol 13 (3) ◽  
pp. e233485 ◽  
Author(s):  
John Xie ◽  
Gerard Chaaya ◽  
Rachna Jetly-Shridhar ◽  
Thomas Stewart Atkinson
Keyword(s):  
Autoimmune Diseases ◽  
Immune Thrombocytopenia ◽  
Reticulocyte Count ◽  
Parvovirus B19 ◽  
Evans Syndrome ◽  
Malignant Thymoma ◽  
Appropriate Treatment ◽  
Autoimmune Condition ◽  
Parvovirus B19 Infection ◽  
Rbc Transfusion

Malignancies are often associated with autoimmune diseases, which are addressed by treating the underlying cancer. However, there are rare malignancies that can cause autoimmune diseases even after appropriate treatment. Our patient is a 39-year-old Hispanic man with a malignant thymoma recently treated with chemotherapy and radiation who presented with syncope and dyspnoea. He was found to be both anaemic and thrombocytopenic. His labs were consistent with autoimmune haemolytic anaemia (AIHA), except his reticulocyte count was unexpectedly low. Bone marrow biopsy supported a diagnosis of Evans syndrome, a rare autoimmune condition characterised by (AIHA) combined with immune thrombocytopenia. He was also found to have an acute parvovirus B19 infection. He was treated with steroids and RBC transfusion. His blood counts gradually returned to baseline, with improvement in symptoms. This patient’s thymoma treatment and active parvovirus B19 infection likely both played a role in the development of Evans syndrome.

Pure Red Cell Aplasia Related to Parvovirus B19 Infection in Simultaneous Pancreas and Kidney Recipient: A Case Report

2020 ◽  
Vol 52 (8) ◽  
pp. 2539-2543 ◽  
Author(s):  
Ewa Nowacka-Cieciura ◽  
Ewa Karakulska-Prystupiuk ◽  
Anna Żuk-Wasek ◽  
Wojciech Lisik ◽  
Grzegorz Władysław Basak ◽  
...  
Keyword(s):  
Case Report ◽  
Parvovirus B19 ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Red Cell Aplasia ◽  
Parvovirus B19 Infection ◽  
Kidney Recipient
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