Parvovirus b19-viremia. clinical and laboratory presentation
Keywords:
parvovirus B19, hemorrhagic maculopapular dermatitis, polyserositis, hepatosplenomegaly, leukopenia, neutropenia, thrombocytopenia, anemia, childrenAbstract
Parvovirus B19 (PVB19), (formerly erythrovirus B19) is the etiological agent of the so-called «Fifth disease», which is mainly found in childhood and adoles-cence, but is also associated with polymorphic clinical presentation, aplastic crises, hemolytic anemia, thrombocytopenia etc., and in pregnant women — unauthorized abortions.Clinical case. Reported a case of PVB19 viremia, which in a 2-year-old patient was the cause of systemic damage. Attention is focused on the long-term differential diagnosis of exanthema in combination with hepatosplenomegaly, polyserositis and leukopenia with neutropenia, anemia and thrombocytopenia of infectious and non-infectious origin, including excluded the neoplastic process, collagenosis. To verify the diagnosis, numerous microbiological tests, aspiration and trepanation bone marrow (BM) biopsy were performed, puncture of pleural fluid, skin biopsy, imaging methods were used: ultrasound (ultrasound), chest Х-ray, computed tomography. In ВM, cytological and histological studies revealed giant erythroid cell elements in the pronormoblast stage with pronounced intranuclear inclusions with chromatin pressed to the periphery of the nucleus, which led to the suspicion of PVB19 infection, which was confirmed using the polymerase chain reaction method. Recovery of the child occurred after the use of methylprednisolone at a dose of 2.7 mg/kg for 28 days with a gradual withdrawal of the medication.
Conclusions. In our opinion, this topic is relevant in the practice of doctors of various specialties, since the timeliness, adequacy and result of treatment depend on the correct verification of the clinical diagnosis.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institution. The informed consent of the child's parents was obtained for the research.
No conflict of interest was declared by the authors.
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