II. Pathophysiology

  1. Parvovirus B19 infection interrupts Red Blood Cell production by affecting erythroid precursors in marrow
  2. Results in high Red Blood Cell turn-over

III. Differential Diagnosis

  1. Sickle Cell Hemolytic Crisis
  2. Splenic Sequestration

IV. Symptoms

V. Signs

  1. May be fully compensated with normal Heart Rate and Blood Pressure
  2. Pallor
  3. Tachycardia
  4. Hypotension

VI. Labs

  1. Hemoglobin decreased from baseline
  2. Reticulocyte Count decreased (approaches 0)
    1. Secondary to decreased Red Blood Cell production despite acute Anemia
    2. Contrast with Sickle Cell Hemolytic Crisis and Splenic Sequestration where the Reticulocyte Count is increased

VII. Differential Diagnosis

VIII. Management

  1. Admit with isolation droplet precautions (due to Parvovirus B19)
    1. Avoid exposing pregnant women
  2. Consult hematology
  3. Intravenous Immunoglobulin (IVIG)
  4. Blood Transfusion may be needed
    1. Blood should be cross-matched, Leukocyte depleted, and irradiated
    2. If stable, avoid Fluid Overload by slow infusion over 4 hours
    3. Plan to raise Hemoglobin by 1 g/dl

IX. Course

  1. Aplasia typically resolves over 1-2 weeks
  2. After infection resolution, immunity to Parvovirus B19 reduces risk of recurrent aplastic crisis

X. References

  1. Glassberg and Weingart in Majoewsky (2012) EM: Rap 12(8): 5-6
  2. Lowe and Wang (2018) Crit Dec Emerg Med 32(11): 17-25

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Ontology: Transient acquired pure red cell aplasia (C0451688)

Concepts Disease or Syndrome (T047)
ICD10 D60.1
SnomedCT 191255003
English Trnsnt acqd pur red cell aplas, transient acquired pure red blood cell aplasia, red blood cell aplasia acquired transient pure, transient acquired pure red blood cell aplasia (diagnosis), Transient acquired pure red cell aplasia, Transient acquired pure red cell aplasia (disorder)
German Transitorische erworbene isolierte aplastische Anaemie
Korean 일과성 후천성 순수적혈구 무형성
Dutch Voorbijgaande verworven 'pure red cell aplasia'
Spanish aplasia eritrocítica pura, adquirida, transitoria (trastorno), aplasia eritrocítica pura, adquirida, transitoria