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[Severe parvovirus B19 infection in an immunocompetent child with hemophilia A]
Insights
A child with hemophilia A developed severe parvovirus B19 infection after receiving clotting factor concentrates. This highlights the risk of virus transmission through plasma-derived products.
Area of Science:
- Virology
- Hematology
- Infectious Diseases
Background:
- Parvovirus B19 is a common virus causing erythema infectiosum, acute erythroblastopenia, and fetal anemia in immunocompetent children.
- Hemophilia A is a genetic bleeding disorder requiring regular treatment with clotting factor concentrates.
Observation:
- An 11-year-old immunocompetent boy with hemophilia A presented with hemorrhagic syndrome.
- Following treatment with pasteurized and solvent/detergent-treated factor VIII concentrates, he developed fever, neurological symptoms, pancytopenia, and liver cytolysis.
- Retrospective analysis revealed daily administration of parvovirus B19 PCR-positive batches for 12 days prior to symptom onset.
Findings:
- The patient experienced a probable minor hemophagocytic syndrome associated with human parvovirus B19 infection.
- His clinical condition resolved spontaneously within 15 days.
- The clotting factor concentrate batches were confirmed to be positive for parvovirus B19 via PCR.
Implications:
- This case demonstrates the potential for severe parvovirus B19 transmission via clotting factor concentrates derived from large plasma pools.
- The use of recombinant clotting factors could minimize viral contamination risks.
- Further assessment is needed to evaluate the immune risks associated with recombinant factor therapies.
Background:
B19 parvovirus is a widespread virus whose typical manifestations in immunocompetent children are erythema infectiosum, acute erythroblastopenia and fetal anemia.
Case Report:
An 11 year-old immunocompetent patient with hemophilia A was referred for an hemorrhagic syndrome. Forty days after a pasteurized coagulation factor concentrates treatment, and after 12 days of treatment with solvent/detergent factor VIII concentrates, he developed fever, consciousness disorders, pancytopenia, liver cytolysis and probably minor haemophagocytic syndrome, associated with human parvovirus B19 infection. His clinical state returned to normal within 15 days. A retrospective study revealed that the patient had received every day for 12 days, one parvovirus B19 polymerase chain reaction positive batch before the occurrence of symptoms.
Conclusion:
This case highlights the possibility of severe parvovirus B19 infection transmitted by clotting factors prepared from large pools of plasma. The use of recombinant factors would allow to reduce human virus contamination, even if immune risk has to be more accurately assessed.