Clinical presentation of parvovirus B19 infection in children with aplastic crisis

Area of Science:

• Pediatrics
• Hematology
• Infectious Diseases

Background:

• Parvovirus B19 is a common cause of aplastic crisis.
• Children with underlying hemoglobinopathies or red blood cell disorders are at higher risk.

Purpose of the Study:

• To describe the clinical presentation and course of parvovirus B19-induced aplastic crisis in children with sickle cell hemoglobinopathies and hereditary spherocytosis.
• To compare the presentation of parvovirus B19 infection in these children to that in normal children.

Main Methods:

• Retrospective review of medical records of 22 children with parvovirus B19-induced aplastic crisis.
• Analysis of patient demographics, symptoms, time to hospital presentation, and laboratory findings.

Main Results:

• The study included 16 children with sickle cell hemoglobinopathies and 6 with hereditary spherocytosis.
• Fever was the most common symptom (73%). Rash was absent in both groups.
• Children with sickle cell disease presented earlier (mean 1.4 days) than those with hereditary spherocytosis (mean 5 days; P = 0.02).
• Reticulocyte counts and parvovirus B19-specific IgG antibodies rose approximately 1 week after illness onset.

Conclusions:

• Parvovirus B19 infection in children with sickle cell hemoglobinopathies and hereditary spherocytosis presents differently than in healthy children.
• Fever is a prominent symptom, and rash is notably absent.
• Delayed recovery is indicated by the timing of reticulocyte count and antibody rise.