Aplastic crisis associated with parvovirus B19 in an adult with hereditary spherocytosis.
Parvovirus B19 is usually associated with an acute, self-limited disease in children. In patients with a congenital hemolytic anemia, infection with this virus can cause an aplastic crisis. We describe such a crisis in an adult with asymptomatic hereditary spherocytosis. The association between acute red blood cell aplasia and infection with parvovirus B19 is well described in patients with hereditary hemolytic anemia, particularly sickle cell anemia. This association has also been described, although less frequently, in patients with other inherited hemolytic diseases, such as hereditary spherocytosis. In children, human parvovirus B19 causes an acute self-limited illness known as erythema infectiosum (fifth disease). In immunocompromised individuals, chronic infections can occur and cause a severe, persistent anemia. In pregnant women, infection can, but usually does not, lead to fetal infection. An infected fetus can have severe anemia, congestive heart failure, generalized edema (fetal hydrops) and even death. Most cases of aplastic crises associated with parvovirus B19 in patients with hereditary spherocytosis have been reported in children and adolescents. In this paper we describe an aplastic crisis in a 28 year old man with asymptomatic hereditary spherocytosis.