Pure Red Cell Aplasia Secondary to Parvovirus B19 Infection in HIV Positive Patients. Clinical and Seroepidemiological Description and Observations in A Third Hospital Level In Colombia

Objective: Describe the clinical and seroepidemiological characteristics and the impact on morbidity and mortality and health costs of patients infected with HIV and red cell aplasia and positive serology for Parvovirus B 19. Methodology: Descriptive and retrospective study, of the clinical and seroepidemiological characteristics of cases of aplasia of the red series without affecting hematimetric indices in HIV positive patients with positive serology to Parvovirus B19, were descripted in an hospitalization service in the period from April 2016 to April 2017. Serum samples from the 16 patients enrolled for the study were analyzed by IgG and IgM type antibodies using the enzyme immunoassay technique. Other causes of anemia, such as: iron-deficiency anemia, invasive fungal infection were ruled out. Results: A total of 16 cases were documented, 11 men (69%) and 5 women (31%) with an average age of 40.7 and 44.4 years respectively, 5 of the 16 patients (31.25%) had positive IgM levels (distributed among 3 men and 2 women) without IgG activity documented in the same sample and 4 of these 5 patients were without treatment for their HIV (80%), none of the patients received regular treatment for HIV. The average in grams per deciliter of hemoglobin and hematocrit at the time of sampling was 8.92 g / dl and 28.6 g / dl respectively, the average of CD4 cell count was 115 for the male population and 187.2 for the female population, the average viral load was 515,483 and 369,390 copies / ml for men and women respectively. No patient received adjuvant treatment directed at the pure red anemia demonstrated. Conclusion: Persistent parvovirus B19 infections in human immunodeficiency virus type 1 infected patients have been reported. The two viruses could share common target cells. The co-infection by Parvovirus B19 is associated with longer days of hospital stay, costs and complications such as nosocomial infections and need of poly transfusions.

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Pure red cell aplasia due to parvovirus B19 in a patient treated with rituximab

Blood ◽

10.1182/blood.v96.3.1184 ◽

2000 ◽

Vol 96 (3) ◽

pp. 1184-1186 ◽

Cited By ~ 93

Author(s):

Vivek R. Sharma ◽

Donald R. Fleming ◽

Stephen P. Slone

Keyword(s):

Monoclonal Antibody ◽

B Lymphocytes ◽

Parvovirus B19 ◽

Pure Red Cell Aplasia ◽

Red Cell ◽

Humoral Immune ◽

Red Cell Aplasia ◽

Point Of Interest ◽

Humoral Immune System ◽

Parvovirus B19 Infection

Abstract Rituximab is a chimeric monoclonal antibody directed against CD20 and used in the treatment of B-cell non-Hodgkin's lymphoma. Due to its ability to deplete B lymphocytes, rituximab can interfere with humoral immunity, causing it to be suppressed for several months after treatment. The reported case depicts a serious consequence of this effect of rituximab therapy: pure red cell aplasia resulting from chronic parvovirus B19 infection. The point of interest in this case is not only the association between rituximab therapy and pure red cell aplasia, but the diagnostic and therapeutic utility of the knowledge of parvovirus B19 as the likely etiologic link between the two. Given the known efficacy of intravenous immunoglobulin (IVIg) in the treatment of chronic parvovirus B19 infection, this therapy can cure some of these patients and successfully render most others transfusion-independent until recovery of their own humoral immune system.

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Pure red cell aplasia due to parvovirus B19 in pediatric malignancies – a report of two cases

Pediatric Hematology Oncology Journal ◽

10.1016/j.phoj.2017.11.065 ◽

2017 ◽

Vol 2 (2) ◽

pp. S19-S20

Author(s):

Putun Patel ◽

Vibha Bafna ◽

Sandip Bartakke ◽

Priya Gupta ◽

Sanjay Mankar ◽

...

Keyword(s):

Parvovirus B19 ◽

Pure Red Cell Aplasia ◽

Red Cell ◽

Pediatric Malignancies ◽

Red Cell Aplasia

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EFFECT OF GLYCAEMIC CONTROL ON PITUITARY GONADOTROPHINS OF TYPE 2 DIABETIC SUBJECTS IN ENUGU, NIGERIA

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v6.i8.2018.1257 ◽

2018 ◽

Vol 6 (8) ◽

pp. 16-24

Author(s):

Maduka Ignatius C ◽

Nnamdi Ngozika A

Keyword(s):

Glycaemic Control ◽

Diabetic Patients ◽

Male Population ◽

Female Population ◽

Control Subjects ◽

Good Glycaemic Control ◽

Diabetic Population ◽

Control Evaluation ◽

Group B ◽

The Impact

Glycation is considered to be the main molecular basis of several diabetic complications. Association between chronic hyperglycaemia and the development of long-term diabetic-specific complications have been reported but are yet to be completely understood. In this study, the effect of glycaemic control on pituitary gonadotrophins (FSH and LH) was evaluated in male and female diabetics in Enugu, Nigeria. Two hundred and twenty four (240) diabetic patients (92 males and 148 females) within the age range of 31 – 73 years, who were receiving treatment, were randomly recruited for the study. One hundred and thirty four (134) age- and sex-matched apparently healthy volunteers (44 males and 90 females) were recruited as the control subjects. The study subjects were grouped into three categories: Male population (40-72 years), Group A Female population (<50 years) and Group B Female population (≥50 years). The impact of glycaemic control on various parameters was evaluated by classifying the diabetic patients into 3 subgroups on the basis of their HbA1c levels: Good (HbA1c < 7%), Fair (HbA1c 7 to 8%) and (Poor HbA1c > 8 %) glycaemic status. Fasting blood sugar, HbA1c, FSH and LH were determined for all the subjects. The results obtained revealed that the male diabetics had significantly lower (p<0.05) FSH levels when compared with the control subjects. In the two groups of female diabetic subjects, the FSH levels were significantly lower (p<0.05) when compared with their respective control subjects. The glycaemic control evaluation and correlation of HbA1c with the gonadotrophins in the male diabetic population show no statistically significant results. However, in the female diabetic population, subjects with poor glycaemic status show significantly increased (p<0.001) LH levels compared to those with good glycaemic control. In addition, in group B female diabetic population, HbA1c gave significant positive correlation with both FSH (r=0.261, p=0.014) and LH (r = 0.338, p<0.001). This suggests that there is a direct relationship between HbA1c and the gonadotrophic hormones. As glycaemic control is compromised, these hormones tend to increase. This study generally reveals increasing trend in the levels of the gonadotrophins across the different glycaemic status. It can be concluded that good glycaemic control of diabetes can exert better influences on pituitary gonadotrophins.

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Pure red cell aplasia caused by Parvo B19 virus in a kidney transplant recipient

Journal of Nepal Medical Association ◽

10.31729/jnma.73 ◽

2012 ◽

Vol 52 (186) ◽

Cited By ~ 2

Author(s):

A Baral ◽

B Poudel ◽

R K Agrawal ◽

R Hada ◽

S Gurung

Keyword(s):

Bone Marrow ◽

Transplant Recipient ◽

Intravenous Immunoglobulin ◽

Kidney Transplant ◽

Parvovirus B19 ◽

Kidney Transplant Recipient ◽

Pure Red Cell Aplasia ◽

Red Cell ◽

Erythroid Progenitor ◽

Red Cell Aplasia

Parvo B19 is a single stranded DNA virus, which typically has affi nity for erythroid progenitor cells in the bone marrow and produces a severe form of anemia known as pure red cell aplasia. This condition is particularly worse in immunocompromised individuals. We herein report a young Nepali male who developed severe and persistent anaemia after kidney transplantation while being on immunosuppressive therapy. His bone marrow examination revealed morphological changes of pure red cell aplasia, caused by parvovirus B19. The IgM antibody against the virus was positive and the virus was detected by polymerase chain reaction in the blood. He was managed with intravenous immunoglobulin. He responded well to the treatment and has normal hemoglobin levels three months post treatment. To the best of our knowledge, this is the fi rst such case report from Nepal. Keywords: Intravenous immunoglobulin, kidney transplant recipient, Parvovirus B19, pure red cell aplasia.

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Mortality Rate Due to Circulatory and Alcohol-Dependent Diseases in Different Climatic Zones of Russia

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.537 ◽

2019 ◽

Vol 7 (11) ◽

pp. 1867-1872

Author(s):

Tatiana P. Yakovleva ◽

Natalia I. Nikitina ◽

Zhanna R. Gardanova ◽

Natalia S. Mikhailova ◽

Albina V. Gaponenko ◽

...

Keyword(s):

Climatic Zone ◽

Male Population ◽

Climatic Zones ◽

Female Population ◽

Risk Of Death ◽

Average Annual Temperature ◽

Circulatory System Diseases ◽

Murmansk Region ◽

The Impact ◽

Alcohol Dependent

AIM: Evaluation of the impact of climatic factors on the formation of mortality due to circulatory diseases and a group of diseases related to alcohol consumption identified as alcohol-dependent. METHODS: The study subject was the adult population residing in different climatic zones of Russia: in the second, third and fourth zones, with different conditions: average annual temperature (5.2°C; 1-2°C; -2.0°C), snow cover duration (≤ 150 days, ≤ 180 days, ≈ 220 days) sunshine duration and the presence of polar night and polar day in the territory of the fourth climatic zone. The assessment “impact-case of death” was carried out by calculating the standardized incidence ratio (SIR) with 95% confidence intervals (CI) for circulatory system diseases (CSD) and alcohol-dependent diseases (ADD) in accordance with the international classification of diseases (ICD-X). RESULTS: The SIR of death from alcohol-dependent diseases for the female population in the 4th climatic zone (Murmansk Region) was the highest: the SIR of death from ADD 1.87; 95% CI (1.5-2.7), the SIR of death from CSD 1.3; 95% CI (1.2-2.3). For the female population in the 3rd climatic zone (Novosibirsk Region), the SIR of death has amounted to: SIRADD 1.52; 95% CI (1.2-1.87), SIRCSD 1.14; 95 CI (1.01-1.3). Living in the 3rd climatic zone was not so important for the health of the male population: the SIR of death from CSD 1.1; 95% CI (1.05-1.13); the SIR of death from ADD 0.8; 95% CI (0.65-0.98). However, living in the 4th climatic zone (Murmansk Region) poses a higher risk of death for the male population: SIRCSD 1.22 (22.0%); 95% CI (1.02-3.95); SIRADD 1.45 (45.0%); 95% CI (0.98-2.1). CONCLUSION: Living in high northern latitudes contributes to higher levels of mortality, both female and male, from circulatory and alcohol-dependent diseases.

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Pure Red Cell Aplasia Related to Parvovirus B19 Infection in Simultaneous Pancreas and Kidney Recipient: A Case Report

Transplantation Proceedings ◽

10.1016/j.transproceed.2020.01.127 ◽

2020 ◽

Vol 52 (8) ◽

pp. 2539-2543 ◽

Cited By ~ 1

Author(s):

Ewa Nowacka-Cieciura ◽

Ewa Karakulska-Prystupiuk ◽

Anna Żuk-Wasek ◽

Wojciech Lisik ◽

Grzegorz Władysław Basak ◽

...

Keyword(s):

Case Report ◽

Parvovirus B19 ◽

Pure Red Cell Aplasia ◽

Red Cell ◽

Red Cell Aplasia ◽

Parvovirus B19 Infection ◽

Kidney Recipient

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Etiologies and Treatment Burden in Adult Patients with Pure Red Cell Aplasia: A Single-Center Experience and Review of Literature

Anemia ◽

10.1155/2020/4812759 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Pimjai Niparuck ◽

Wasana Kanoksil ◽

Pathawut Wacharapornin ◽

Pichika Chantrathammachart ◽

Sarinya Boongird

Keyword(s):

Response Rate ◽

Parvovirus B19 ◽

Pure Red Cell Aplasia ◽

Adult Patients ◽

Red Blood Cell Transfusion ◽

Red Cell ◽

Treatment Burden ◽

Intravenous Immunoglobulin Therapy ◽

Red Cell Aplasia ◽

Blood Disorder

Background. Pure red cell aplasia (PRCA) is less common blood disorder; the causes and the treatments of PRCA are varied. Methods. We conducted a retrospective study during January 2010–December 2017, to explore the etiologies and to evaluate the response and treatment burden in adult patients with PRCA. Results. Of 32 PRCA patients, median age was 57 years (18–90 years). Median hemoglobin level and reticulocyte count at the time of diagnosis were 5.6 g/dL (3.3–7.3 g/dL) and 0.3% (0.1–0.7%), respectively. Median time to hematologic recovery was 12 weeks (3–72 weeks), and median number of red blood cell transfusion (RBC) was 20 units (4–100 units). Causes of PRCA were erythropoiesis-stimulating agent (ESA) (47%), parvovirus B19 infection (19%), thymoma (13%), zidovudine (6%), primary autoimmune PRCA (6%), Kaposi’s sarcoma (3%), systemic lupus erythematosus (3%), and ABO-mismatched stem cell transplantation (3%). Only 9 out of 24 treated patients achieved hematologic response within 8 weeks of treatment. Intravenous immunoglobulin therapy provided 100% response rate in patients with parvovirus B19-associated PRCA and primary autoimmune PRCA. Low response rate was found in patients receiving immunosuppressants and chemotherapy for the treatment of ESA and thymoma-associated PRCA, respectively. Conclusions. Treatment outcome of PRCA depended upon the causes and the types of treatment, and the burden of RBC transfusion was very high in patients with ESA and thymoma-associated PRCA.

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