Aplastic Crisis

In this article, we will discuss the Aplastic crisis. So, let’s get started.

Definition

It is frequently seen in congenital hemolytic anemia such a sickle cell anemia, beta-thalassaemia, hereditary spherocytosis and pyruvate kinase deficiency. The infection by B19 parvovirus is the most common precipitating cause. It may be sporadic or endemic. Transmission of virus is via feco-oral root or droplets infection.

The symptoms and signs of infection such as fever, malaise, chills, upper respiratory or gastrointestinal symptoms precede the episode of aplastic crisis. The investigations reveal very low haemoglobin and hypoplasia of the bone marrow (low reticulocyte count, erythroblastopenia). Diagnosis is mainly clinical. Serology for presence of specific IgM antiviral antibodies or demonstration of parvovirus B19 particles in the blood on electron microscopy is confirmatory. Erythropoiesis ceases for 48-72 hours, though crisis will last for 1 to 2 weeks. Treatment is immediate red cell infusion to raise the hemoglobin. Supportive care should be instituted. The crisis is self limiting. A single attack of parvovirus confers lifelong immunity.

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