Anemia of a mild viral infection: the measles vaccine as a model.
To define the hematologic changes during a mild viral infection, 93 infants were immunized with live attenuated measles virus and studied prospectively at 0, 4, 9, 14, 21, and 30 days. Hemoglobin concentration decreased significantly by days 9 and 14. The decrease was greater than 1.0 g/dL in 8.6% and greater than 0.6 in 24.3% of the infants. Of the nonanemic infants, 22% became anemic. Serum iron and percentage saturation of transferrin decreased, whereas serum ferritin increased significantly. Mean cell volume, iron-binding capacity, protoporphyrin, and haptoglobin did not show changes. Reticulocyte index and erythropoietin increased significantly at 30 days. Leukocyte counts, Zetacrit, and C-reactive protein did not help to predict the hemoglobin decrease. These results suggest that a mild viral infection in infants induces a significant decrease in hemoglobin that may persist for 14 to 30 days and may be difficult to distinguish from iron deficiency.
Olivares
M
M
Hematology Unit, Universidad de Chile, Santiago.
Walter
T
T
Osorio
M
M
Chadud
P
P
Schlesinger
L
L
D000740:Anemia / Q000209:etiology*; D004909:Erythrocyte Indices; D004921:Erythropoietin / Q000097:blood; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D007501:Iron / Q000097:blood; D007958:Leukocyte Count; D008458:Measles Vaccine / Q000009:adverse effects*; D012156:Reticulocytes; D014168:Transferrin / Q000032:analysis; D014613:Vaccines, Attenuated / Q000009:adverse effects; D014777:Virus Diseases / Q000097:blood / Q000150:complications*
D006454:Hemoglobins; D008458:Measles Vaccine; D014168:Transferrin; D014613:Vaccines, Attenuated; D004921:Erythropoietin; D005293:Ferritins; D007501:Iron