title: An adult with aplastic crisis induced by human parvovirus B19 as an initial presentation of hereditary spherocytosis.
abstract: The association between aplastic crisis and human parvovirus (HPV) B19 infection is well described in patients with sickle cell anemia. This association has also been described, although much less frequently, in patients with hereditary spherocytosis (HS). However, most cases of aplastic crises in patients with HS and induced by HPV B19 have been reported in children or adolescents. In this paper, we describe an aplastic crisis induced by HPV B19 in an adult with HS. A 34-year-old female presented with presyncope, febrile sensation, and myalgia. The complete blood counts showed severe anemia. The peripheral blood smear revealed spherocytosis with reticulocytopenia and pancytopenia. The direct Coombs' test was negative; the osmotic fragility test was positive. In the bone marrow aspirates, a few giant pronormoblasts with deep blue cytoplasm, pseudopods, and intracellular inclusion bodies were observed. The patient was given eight units of packed red blood cells. HPV B19 infection was proven by the presence of IgM antibodies to HPV B19 and the detection of viral DNA using the PCR technique. To the best of our knowledge, this is the first report in Korea that describes an adult with aplastic crisis presenting initially with HS.
authors.affiliation: Department of Intemal Medicine, College of Medicine, Hallym University, Seoul, Korea.
authors.forename: Sook Eui
authors.initials: SE
authors.lastname: Oh
authors.forename: Jung Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Chi Hun
authors.initials: CH
authors.lastname: Choi
authors.forename: Kwang Hyuk
authors.initials: KH
authors.lastname: Park
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Jung
authors.forename: Young lee
authors.initials: Yl
authors.lastname: Park
authors.forename: Min-Jeong
authors.initials: MJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000741:Anemia, Aplastic / Q000209:etiology*; D005260:Female; D006801:Humans; D010322:Parvoviridae Infections / Q000150:complications* / Q000175:diagnosis; D016732:Parvovirus B19, Human; D013103:Spherocytosis, Hereditary / Q000175:diagnosis*