[Transient erythroblastopenia in the context of Epstein-Barr virus infection]

The authors report the case of a previously healthy 5-year-old boy who, 1 month after tonsillitis, presented severe aregenerative anemia, macrocytosis, and increased hemoglobin F associated with mild thrombocytopenia. Peripheral blood smear showed no significant alterations and bone marrow aspirate revealed markedly decreased red blood cell precursors. Etiological investigation showed elevated titers of Epstein-Barr virus antibodies (IgM anti-viral capsid antigen). Bone marrow biopsy showed no criteria for red cell aplasia and in situ hybridization revealed intracellular Epstein-Barr virus. Reticulocytosis emerged from days 10-17 of follow-up, together with rising hemoglobin. Mean corpuscular volume and hemoglobin F returned to normal 2 months later. Immunological study revealed partial IgG3 deficit that persisted after 1 year of follow-up.