Autoimmune hemolytic anemia with concurrent acute parvovirus B19 infection in a heterozygous for sickle cell patient and literature review

摘要

Parvovirus B19 presents with erythema infectiosum, hydrops fetalis, and anemia in patients with thalassemia, sickle cell disease (SCD), or hereditary spherocytosis. Indeed, it is implicated in autoimmune disorders, though it has been rarely reported in relation to autoimmune hemolytic anemia (AIHA) [1-7]. We present a patient with sickle cell trait that developed severe AIHA and acute parvovirus B19 infection. Parvovirus B19 is a common infection in childhood (50%) and can result in a wide spectrum of clinical conditions depending on the patient's immunological and herna-tological status. Its prevalence increases with age, exciting 60% in adulthood. Parvovirus B19 is associated with several clinical conditions such as erythema infectiosum, transient aplastic crisis, chronic red cell aplasia, arthropathy, gloves and socks syndrome, and hydrops fetalis. It is also implicated in autoimmune diseases both in children and adults, though it has been rarely reported in association with AIHA. In patients with congenital or acquired hemolytic anemia, parvovirus B19 usually induces a transient aplastic anemia. We here report a 4-year-old white girl with sickle cell trait that developed severe AIHA following an acute parvovirus B19 infection.