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Díez de los Ríos, E. Reynaga, D. Badia" "autores" => array:3 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Díez de los Ríos" "email" => array:1 [ 0 => "jdiez@chv.cat" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "E." "apellidos" => "Reynaga" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "D." 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The laboratory tests revealed the following: hemoglobin, 6.8<span class="elsevierStyleHsp" style=""></span>g/dL; hematocrit, 20.0%; mean corpuscular volume, 79.2<span class="elsevierStyleHsp" style=""></span>fL; and mean corpuscular hemoglobin, 27.0<span class="elsevierStyleHsp" style=""></span>pg. The patient was diagnosed with heterozygous hemoglobin S disease and monoclonal gammopathy of undetermined significance. The blood cultures were negative, the CD4+ lymphocyte count was 50<span class="elsevierStyleHsp" style=""></span>c/mm<span class="elsevierStyleSup">3</span>, and the HIV RNA viral load was 5222<span class="elsevierStyleHsp" style=""></span>copies/mL. During hospitalization, the patient required 6 units of packed red blood cells due to persistent anemia. A bone marrow aspirate revealed an increased proportion of plasma cells. The bone marrow biopsy showed hypercellularity for the patient's age, panmyelosis and cytopathic changes in the erythroid series consistent with infection by parvovirus B19 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A, hematoxylin-eosin staining), confirmed through immunohistochemistry (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). The IgM and IgG serology for parvovirus B19 was positive. The patient was treated with immunoglobulins 1<span class="elsevierStyleHsp" style=""></span>g/kg divided into 2 days, resulting in progressive clinical and analytical improvement.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Parvovirus-related anemia in patients infected by HIV is uncommon, suggesting a diagnosis of normochromic normocytic anemia, with no reticulocytes or renal dysfunction. Most patients with CD4 counts <100<span class="elsevierStyleHsp" style=""></span>cells/mm<span class="elsevierStyleSup">3</span> can relapse into anemia, typically within the first 6 months.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-02-28" "fechaAceptado" => "2018-03-19" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Díez de los Ríos J, Reynaga E, Badia D. Infección por parvovirus B19: una inusual etiología de anemia. Rev Clin Esp. 2018;218:447–448.</p>" ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 722 "Ancho" => 1254 "Tamanyo" => 238726 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000021800000008/v1_201810300615/S2254887418300663/v1_201810300615/en/main.assets" "Apartado" => array:4 [ "identificador" => "71811" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Medicine in images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021800000008/v1_201810300615/S2254887418300663/v1_201810300615/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887418300663?idApp=WRCEE" ]
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