Sickle Cell Anemia Case Report Focuses on Viral Infection in 2 Brothers

In sickle cell anemia (SCA), infection with the erythrovirus B19 (B19V) is known to cause transient aplastic crises, in which  production of red blood cells (RBCs) in the bone marrow fails.

In this study, researchers describe the clinical course and lab tests of two brothers with sickle cell disease who had the infection. The findings suggest that host immunologic background plays an important role in the clinical course of such crises secondary to B19V infection.

The research paper, “Transient red cell aplasia in two brothers with sickle cell anemia and erythrovirus B19 infection,” published in Revista Brasileira de Hematologia e Hemoterapia, suggests that reticulocyte-immature red blood cell count is essential for early adequate treatments, as symptoms can be life-threatening.

Diagnosis of  B19V infection, which is associated with many clinical manifestations depending on the immunological and hematological status of the patient, can be achieved by detecting anti-B19V antibodies or by molecular biology techniques that allow the detection of viral DNA.

A study that enrolled 278 children with sickle cell disease showed that past or recent viral infection occurred in 29.5 percent of the young patients. Here, researchers describe the cases, including the symptoms and tests performed, of two brothers that participated in this study. Both brothers were diagnosed with B19V infection and presented different symptoms.

Researchers highlight that familial transmission of B19V infection is important in viral spread, as it has been demonstrated that the single risk factor for B19V seroconversion in a child was a sibling with a recent B19V infection. The rate of secondary infection in families with two or more children with sickle cell disease was 56.3 percent, a study found.

“In conclusion, our report suggests that host immunologic background may play a significant role in the pathogenesis and clinical course of aplastic crises secondary to B19V infection, as both brothers showed life-threatening clinical manifestations,” the researchers wrote.

“Since serological and molecular tests are not always available, the reticulocyte count is essential when transient bone marrow hypoplasia caused by B19V is suspected, so that proper supportive care can be immediately started.”