Journal Article

Parvovirus B19-induced Thrombocytopenia and Anemia in a Child with Fatal Fulminant Hepatic Failure Coinfected with Hepatitis A and E Viruses

Janak Kishore and Manodeep Sen

in Journal of Tropical Pediatrics

Volume 55, issue 5, pages 335-337
Published in print October 2009 | ISSN: 0142-6338
Published online February 2009 | e-ISSN: 1465-3664 | DOI: http://dx.doi.org/10.1093/tropej/fmp004
Parvovirus B19-induced Thrombocytopenia and Anemia in a Child with Fatal Fulminant Hepatic Failure Coinfected with Hepatitis A and E Viruses

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A 5-year-old male, drowsy, jaundiced child presented with fulminant hepatitis and had HAV and HEV infection. He had hepatic encephalopathy grade 1, fever, pallor, hypotension, crepitations in his right lung base and hepatosplenomegaly with dyspnoea. He had highly raised liver enzymes and hypoalbuminemia (2.8 g/dl) but anemia (hemoglobin of 7.7 g/dl and 5.7 g/dl 2 days later), reticulocytopenia and severe thrombocytopenia (44 × 109/l) were unexplained. Parvovirus B19-specific IgM antibodies and B19 DNA were found in the serum of the child. Chest X-ray showed pleural effusion and bronchopneumonia, while blood culture isolated coagulase-negative staphylococci (BACTEC 9120) and he had low oxygen saturation. Hence, he was treated with IV amoxicillin+ clavulinic acid and oxygen inhalation. He had seizures and cardiac arrest but was revived. On the third day his condition worsened and the child died despite intensive care. Hence it is concluded that his anemia and thrombocytopenia were B19 induced and this might have aggravated or caused fulminant hepatitis.

Keywords: hepatitis; liver failure; PCR; parvovirus B19

Journal Article.  1206 words. 

Subjects: Paediatrics

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