Anemia hemolítica secundaria a Parvovirus B19

Abstract

This research work is about a 13-year-old male patient who presents a 3-day evolutionary picture characterized by severe abdominal pain, nausea that comes to vomit on 2 occasions, anorexia, malaise and referred thermal rise but not quantified. Initially, it was interpreted as Acute Appendicitis at the Basic Hospital from Guamote and transferred by emergency to the Hospital of the Ecuadorian Social Security Institute in Riobamba. Along the evaluation, conjunctiva and pale oral mucous, dehydration, abdominal pain located in the right hypochondrium that radiates to the right iliac fossa, and 38.5°C fever were observed; while in the laboratory tests, Leukocytes 6800mm3, Hemoglobin 10gr/dl, Hematocrit 29.3%, Neutrophils 89.7%, Platelets 283,000mm3, Reticulocytes of 1,2 and Lactate Dehydrogenase 600 u/l. In the first 24 hours after admission, the clinical picture changes, increasing general malaise; in addition, it emerges coluria, tachycardia, tachypnea, oxygen desaturation, and fever of 39°C; however, it occurs Leukopenia 1,000mm3, Absolute Neutrophil Count of 467mm3, Hematocrit 19.8%, Hemoglobin 6.7gr/l, Platelets 114,000mm3, with pancytopenia, hyperbilirubinemia at the expense of Indirect Bilirubin 5.13mg/dl, reactants of high acute phase, and direct negative Coombs. Globular concentrates were administered twice and antibiotic-therapy was established. The laboratory study allowed to establish the certainty diagnosis of Secondary Hemolytic Anemia to Parvovirus B19, determining by the means of a study of Parvovirus B19 positive for IgG and IgM.