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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 38-year-old woman&#44; native of Ghana&#44; with a history of human immunodeficiency virus infection with irregular follow-up&#44; no antiretroviral therapy&#44; consulted for fever and asthenia that started one week earlier&#46; The laboratory tests revealed the following&#58; hemoglobin&#44; 6&#46;8<span class="elsevierStyleHsp" style=""></span>g&#47;dL&#59; hematocrit&#44; 20&#46;0&#37;&#59; mean corpuscular volume&#44; 79&#46;2<span class="elsevierStyleHsp" style=""></span>fL&#59; and mean corpuscular hemoglobin&#44; 27&#46;0<span class="elsevierStyleHsp" style=""></span>pg&#46; The patient was diagnosed with heterozygous hemoglobin S disease and monoclonal gammopathy of undetermined significance&#46; The blood cultures were negative&#44; the CD4&#43; lymphocyte count was 50<span class="elsevierStyleHsp" style=""></span>c&#47;mm<span class="elsevierStyleSup">3</span>&#44; and the HIV RNA viral load was 5222<span class="elsevierStyleHsp" style=""></span>copies&#47;mL&#46; During hospitalization&#44; the patient required 6 units of packed red blood cells due to persistent anemia&#46; A bone marrow aspirate revealed an increased proportion of plasma cells&#46; The bone marrow biopsy showed hypercellularity for the patient&#39;s age&#44; panmyelosis and cytopathic changes in the erythroid series consistent with infection by parvovirus B19 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#44; hematoxylin-eosin staining&#41;&#44; confirmed through immunohistochemistry &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#46; The IgM and IgG serology for parvovirus B19 was positive&#46; The patient was treated with immunoglobulins 1<span class="elsevierStyleHsp" style=""></span>g&#47;kg divided into 2 days&#44; resulting in progressive clinical and analytical improvement&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Parvovirus-related anemia in patients infected by HIV is uncommon&#44; suggesting a diagnosis of normochromic normocytic anemia&#44; with no reticulocytes or renal dysfunction&#46; Most patients with CD4 counts &#60;100<span class="elsevierStyleHsp" style=""></span>cells&#47;mm<span class="elsevierStyleSup">3</span> can relapse into anemia&#44; typically within the first 6 months&#46;</p></span>"
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Medicine in images
DOI: 10.1016/j.rceng.2018.03.006
Parvovirus B19 infection: An unusual aetiology of anaemia
Infección por parvovirus B19: una inusual etiología de anemia
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J. Díez de los Ríosa,
Corresponding author
jdiez@chv.cat

Corresponding author.
, E. Reynagaa, D. Badiab
a Servicio de Medicina Interna, Hospital Universitari de Vic, Vic, Barcelona, Spain
b Servicio d’Anatomia Patològica, Hospital Universitari de Vic, Vic, Barcelona, Spain

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