Clinical and hematological of parvovirus B19 infection on Egyptian children with chronic hemolytic anemia

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.

Keywords

Chronic hemolytic anemia - parvovirus infection