Parvovirus B19 infection presenting with severe erythroid aplastic crisis during pregnancy in a woman with autoimmune hemolytic anemia and alpha-thalassemia trait: a case reportReportar como inadecuado




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Journal of Medical Case Reports

, 9:58

First Online: 12 March 2015Received: 30 June 2014Accepted: 12 February 2015DOI: 10.1186-s13256-015-0542-7

Cite this article as: Chen, CC., Chen, CS., Wang, WY. et al. J Med Case Reports 2015 9: 58. doi:10.1186-s13256-015-0542-7

Abstract

IntroductionParvovirus B19 virus commonly causes subclinical infection, but it can prove fatal to the fetus during pregnancy and cause severe anemia in an adult with hemolytic diseases. We present the case of a woman with autoimmune hemolytic anemia who was diagnosed with parvovirus B19-induced transient aplastic crisis during her second trimester of pregnancy and faced the high risk of both fetal and maternal complications related to this specific viral infection. To the best of our knowledge, the experience of successful intravenous immunoglobulin treatment for B19 virus infection during pregnancy, as in our case, is limited.

Case presentationA 28-year-old and 20-week pregnant Chinese woman with genetically confirmed alpha-thalassemia trait was diagnosed with cold antibody autoimmune hemolytic anemia and suffered from transient aplastic crisis caused by B19 virus infection. She received intravenous immunoglobulin treatment to reduce the risk of hydrops fetalis. Her peripheral blood reticulocyte percentage recovered, but anemia persisted, so she underwent several courses of high dose intravenous dexamethasone for controlling her underlying hemolytic problem. Finally, her hemoglobin levels remained stable with no need of erythrocyte transfusion, and a healthy baby boy was naturally delivered.

ConclusionsParvovirus B19 virus infection should be considered when a sudden exacerbation of anemia occurs in a patient with hemolytic disease, and the possible fetal complications caused by maternal B19 virus infection during pregnancy should not be ignored. Close monitoring and adequate management can keep both mother and fetus safe.

KeywordsParvovirus B19 Pregnancy Autoimmune hemolytic anemia Transient aplastic crisis Intravenous immunoglobulin AbbreviationsAIHAAutoimmune hemolytic anemia

ANCAbsolute neutrophil count

EBVEpstein-Barr virus

EUEmergency unit

GAPGravida-para-abortus

IVIGIntravenous immunoglobulin

MCA-PSVMiddle cerebral artery peak systolic velocity

MCVMean corpuscular volume

TACTransient aplastic crisis

WBCWhite blood cell

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Autor: Chi-Ching Chen - Chin-Shan Chen - Wei-Yao Wang - Jui-Shan Ma - Hwei-Fan Shu - Frank S Fan

Fuente: https://link.springer.com/







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