个案报道和文献复习：同胞兄弟同时感染微小病毒B₁₉致纯红细胞再生障碍性贫血

A Case Report and Review of the Literature: Pure Red Cell Aplasia Occurs in Two Brothers Caused by Infected with Parvovirus B₁₉

摘要: 目的：本研究报道了同胞兄弟二人因贫血症状就诊，均诊断为微小病毒B₁₉致纯红细胞再生障碍性贫血，旨在提高对微小病毒B₁₉感染特点的了解，尤其是提高其对造血系统影响的认识。方法：回顾性分析1例微小病毒B₁₉感染致纯红细胞再生障碍性贫血的临床资料，对患者进行人微小病毒B₁₉ (DNA)定量检测、骨髓穿刺等检查，同时查阅文献进行总结分析。本病例报道已获得病人家属的知情同意。结果：患者临床表现为发热、乏力，血常规以贫血为主要表现，白细胞偏低，微小病毒B₁₉ (DNA)定量检测结果显示拷贝数较高，IgM抗体阳性，骨髓提示红系比例极低。结论：同胞兄弟二人同时感染微小病毒B₁₉致纯红细胞再生障碍性贫血较为少见。病毒DNA检测及IgM抗体检查，并结合骨髓结果，可明确诊断，治疗无需特殊处理，部分需应用大剂量静注人免疫球蛋白冲击，预后相对较好。

Abstract: Objective: In this study, we reported a case of pure red cell aplasia caused by parvovirus B₁₉ in two brothers with anemia, in order to improve the understanding of the characteristics of parvovirus B19 infection, especially its effect on hematopoietic system. Methods: The clinical data of the case of pure red cell aplasia caused by parvovirus B₁₉ infection were retrospectively analyzed. The patients were examined by quantitative detection of human parvovirus B₁₉ (DNA), Bone Marrow Examination, etc. At the same time, the literature is summarized and analyzed. This case report has obtained the informed consent from the patient’s family. Results: The clinical manifestations of patients were fever, and hypodynamia. Blood analysis suggests anemia and leukopenia. Quantitative detection of parvovirus B₁₉ (DNA) indicated a high copy number and IgM antibody was positive. And bone marrow indicates a very low percentage of erythroids. Conclusion: It is rare that two brothers got pure red cell aplasia at the same time because of infecting with parvovirus B₁₉. It can be diagnosed through viral DNA detection, IgM antibody examination, and Bone Marrow Examination. The treatment is normal, but some patients should use large doses of intravenous immunoglobulins. All patients had achieved good curative effect.