Snapshot A 5-year-old boy with sickle cell anemia presents to the emergency room with a low-grade fever, malaise, and a rash on his cheeks. On physical exam, his cheeks have a “slapped” appearance. His blood tests show Hb of 4.0 g/dL; MCV 90 fl; and 1% reticulocyte count. A bone marrow biopsy is obtained, showing hypocellularity and increased adipose tissue. Introduction Pancytopenia caused by diminished, absent, or destructed hematopoietic stem cells With bone marrow aplasia Epidemiology No racial or gender predisposition Commonly seen in sickle cell patients who are infected with parvovirus B19 ETIOLOGY Multiple different causes login to view 17 more bullets Presentation Symptoms/physical exam login to view 10 more bullets STUDIES Labs login to view 5 more bullets Most accurate test login to view 3 more bullets Differential Diagnosis PNH Myelodysplastic syndrome login to view 5 more bullets Infection DIAGNOSIS Diagnosis of exclusion Treatment Withdrawal causative agent if applicable Supportive therapy login to view 3 more bullets Curative - bone marrow transplant for healthy patients under 50 Medical therapy – immunosuppressive agents for over 50 or those with comorbidities login to view 1 more bullet Medical therapy – hematopoietic growth factors login to view 2 more bullets Complications Infection Bleeding Complications of stem cell transplant login to view 1 more bullet Prognosis 10-year survival rate login to view 2 more bullets