ACUTE PARVOVIRUS B 19 INFECTION MIMICKING MYELODYSPLASTIC SYNDROME OF THE BONE-MARROW

A 36-year-old, previously healthy woman was referred to our institution with pancytopenia and splenomegaly for suspected acute leukemia. Bone marrow aspiration showed marked dysplastic changes, excess of blasts, and only spurious red blood cell precursors. Action was taken to prepare allogeneic bone marrow transplantation from an HLA identical sibling for myelodysplastic syndrome. Repeat cytological examination of the bone marrow revealed striking hyperplasia of the red cell line with presence of abnormal giant proerythroblasts. Acute parvovirus B 19 infection was suspected and confirmed by detection of anti-B 19 IgM and B 19 DNA. The underlying disease for this transient aplastic crisis was a formerly unknown hereditary spherocytosis.