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

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• 作者：Chi-Ching Chen (1)
  Chin-Shan Chen (2)
  Wei-Yao Wang (3)
  Jui-Shan Ma (4)
  Hwei-Fan Shu (5)
  Frank S Fan (6)
  
  1. Department of Internal Medicine ; Feng Yuan Hospital ; No. 100 ; Ankang Road ; Fengyuan District ; Taichung City ; 420 ; Taiwan
  2. Department of Gynecology and Obstetrics ; Feng Yuan Hospital ; No. 100 ; Ankang Road ; Fengyuan District ; Taichung City ; 420 ; Taiwan
  3. Section of Infectious Disease ; Department of Internal Medicine ; Feng Yuan Hospital ; No. 100 ; Ankang Road ; Fengyuan District ; Taichung City ; 420 ; Taiwan
  4. Department of Pediatrics ; Feng Yuan Hospital ; No. 100 ; Ankang Road ; Fengyuan District ; Taichung City ; 420 ; Taiwan
  5. Department of Anatomical Pathology ; Feng Yuan Hospital ; No. 100 ; Ankang Road ; Fengyuan District ; Taichung City ; 420 ; Taiwan
  6. Division of Hematology/Oncology ; Department of Internal Medicine ; Feng Yuan Hospital ; No. 100 ; Ankang Road ; Fengyuan District ; Taichung City ; 420 ; Taiwan
  
• 关键词：Parvovirus B19 ; Pregnancy ; Autoimmune hemolytic anemia ; Transient aplastic crisis ; Intravenous immunoglobulin
• 刊名：Journal of Medical Case Reports
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：9
• 期：1
• 全文大小：1,483 KB
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• 刊物主题：Medicine/Public Health, general; General Practice / Family Medicine; Public Health; Primary Care Medicine;
• 出版者：BioMed Central
• ISSN：1752-1947

文摘

Introduction Parvovirus 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 presentation A 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. Conclusions Parvovirus 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.