Varied Hematological Manifestation Of Parvo Virus Infection

Abstract

Background & Objective: Human parvovirus B19 infections may cause a widespread benign and self-limiting disease in children known as erythema infectiosum or fifth disease. Infections caused by human parvovirus B19 can result in a wide spectrum of manifestations, which are usually influenced by the patient's immunologic and hematologic status. Patients with underlying hematologic and immunologic disorders who become infected with this virus are at risk for aplastic anemia. We studied different hematological manifestations of Parvovirus infection like anemia, thrombocytopenia , eosinophilia and pancytopenia. Methodology: It was a retrospective study in which we studied 17 patients with parvo B 19 virus positivity their clinical presentation, predisposing diseases , CBC parameters and response to treatment. Parvo virus infection was diagnosed by parvo IgM titer(>11NTU considered as positive) .Also BM histopathology was done whenever possible. Results: Out of 17 patients studied with parvo virus B 19 positivity 12(70.58%) were male and 5(29.42%) were female .The age of presentation was between 2.5 to 14year,with mean of 8.7year.Parvo virus infection was seen amongst patients with HIV n=8(47.05% ), Hemolytic anemia n=4(23.52%),ITP n=2(11.76%) and eosinophilia n=1(5.88%), plasmodium falciparum infection n=1(5.88%) & patient with acute lymphocytic leukemia n=1(5.88%).Commonest hematological manifestations were unexplained anemia n=16(94.11%) , thrombocytopenia n=5(29.41%), eosinophilia n=1(7.7%) , bicytopenia n=6(35.29%) , pancytopenia n=2(11.76%). Out of 17 patients 7(41.17%) were treated with IvIg and rest 10 required only supportive care as infection was transient. Conclusion: Parvo virus infection induced anemia is more severe and persistent in immunocompromised patients. Patients with hemolytic anemias may present with transient aplastic crisis due to parvo virus infection. Parvo virus infection may be considered as a possible etiologic agent for ITP. Coexistent Parvo virus infection in patients with P.falci malaria may be a cause for severe anemia. The hematological manifestations of parvovirus infection results from direct consequences of the ability of parvovirus B19 to target the erythroid cell lineage. However, accumulating evidence suggests that this virus can also affect other cell lineages pathogenesis of which remains to be fully elucidated.[Makwana G NJIRM 2015; 6(6): 59-60]