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Parvo virus B19 - Pure Red Cell Anemia

Best-documented viral cause of RBC aplasia in

 

  • Chronic Hemolysis
  • Immunocompromised
  • Fetus in utero

Pathology:

Cytotoxic to marrow erythroid progenitor cells by  binding to red cell "P" antigen.

Clinical course:

Normal children: <2wk course. Anemia not present or appreciated.
            Rx: Not required

Hemolytic patient: brief cessation of erythropoiesis may precipitate Aplastic crisis  in already low lifespan RBC.
Most occurs once in life, but should should be isolated from at risk pts.
           Rx: B.T if required.

Recovery in both the cases is spontaneous, with nucleated RBC & reticulocytosis.

Immuno-compromised: severe, no spontaneous recovery, >1 blood transfusion.
          Rx: High dose IVIG.

In-Utero: ↑ 2nd, 3rd foetal wastage, hydrops fetalis.

Investigations:


Bone marrow under light m/s:
  • decreased erythroid precursors,
  • characteristic nuclear inclusions in erythroblasts
  • giant pronormoblasts
Lab:
  • PCR
  • Serum IgM & IgG titers.

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