Affiliations: Department of Clinical Pathology, Faculty of Medicine,
Mansoura University, Mansoura, Egypt. Tel.: +20 502258877; E-mail: may_s65@hotmail.com
Abstract: Patients with chronic hemolytic anemia are at high risk of
developing acute erythroblastopenia following infection by parvovirus B19
(PB19). The objective of the present study is to evaluate the clinical and
hematological effects of recent and old PB19 infections in Egyptian children
with chronic hemolytic anemia. This study included 90 pediatric patients.
Twenty healthy subjects with matched age and sex were included as controls.
Patients were classified as patients with chronic hemolytic anemia with acute
aplastic crises and patients with chronic hemolytic anemia without aplastic
crises. Full hematological and clinical studies were performed for each
patient. Virological studies for PB19 were applied with measurement of specific
IgM and IgG and real time polymerase chain reaction. Recent PB19 infection in
patients with chronic hemolytic anemia with acute aplastic crises was
associated mainly with fever (77.8%) followed by pallor and
hepatosplenomegaly (38.9% for each). Recent PB19 infection was associated by
significantly lower levels of mean hemoglobin (Hb) (P1= 0.001, P2 < 0.001) compared to patients with past PB19 and
in patients with no markers of infection in patients with aplastic crises
respectively. In patients with chronic hemolytic anemia without aplastic crises
it was observed that recent PB19 infection was associated with significantly
lower levels of the mean Hb compared to patients with past PB19 infection and
patients without markers of infection (P=0.026). In
patients with chronic hemolytic anemia without aplastic crises there was
significant neutropenia in recent infection compared to patients with past
infection and in patients without markers of infection (0.039) and
lymphocytosis in recent infection compared to patients with past infection and
in patients without markers of infection (P=0.001). We can
conclude that recent PB19 infection in patients with chronic hemolytic anemia
usually presents with low Hb levels associated with fever and
hepatosplenomegaly. Even in patients with evidence of past PB19 infection, the finding was lower Hb level.