Parvovirus-Induced Aplastic Crisis in a Child with Hereditary Spherocytosis: Studies on the Mechanisms of Hemopoietic Suppression

Abstract

A 4 4/12-year-old girl with hereditary spherocytosis (HS) who presented with an aplastic crisis during a human parvovirus (HPV) B19 infection is reported. IgM and IgG antibodies to the HPVB19 and HPV19 DNA were detected. Each of Leu 7⁺, Leu 11⁺ and HLA-DR⁺ cells increased. OKT₄/OKT₈ ratio decreased to 0.71. In order to investigate the mechanism of aplastic crisis, we used an in vitro culture technique for erythroid and granulocyte-macrophage progenitor cells (BFU-E, CFU-E and CFU-C). The patient's HPV 19 DNA-containing aplastic phase serum inhibited the formation of BFU-E, CFU-E and CFU-C. After removal of the adherent cells from the aplastic phase bone marrow, the numbers of BFU-E significantly increased. These results suggest that aplastic crisis of the patient with HS was caused by HPVB19, and that monocytes-macrophages and NK cells played an important role in the pathogenesis of aplastic crisis.