[When AIHA does not explain everything: parvovirus B19 infection and pancytopenia as a differential diagnostic...

A 48-year-old female patient with known autoimmune hemolytic anemia (AIHA) presented with severe anemia and pancytopenia. Despite typical hemolysis parameters and a positive direct antiglobulin test confirming the presence of warm autoantibodies, erythropoiesis was found to be hyporegenerative. This constellation suggested a combined mechanism of increased erythrocyte destruction and impaired hematopoietic capacity. Further diagnostic workup revealed active parvovirus B19 infection. This case highlights that the coincidence of AIHA and parvovirus B19 infection can lead to an atypical hematologic presentation and significantly complicate the diagnostic process.