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Vitamin D deficiency
0%
0/10
Beta-thalassemia minor
30%
3/10
Sickle cell disease
Human immunodeficiency virus (HIV) infection
10%
1/10
Hereditary spherocytosis
60%
6/10
Select Answer to see Preferred Response
This patient was infected with parvovirus B19 and developed a transient aplastic crisis (anemia only, unlike aplastic anemia which causes pancytopenia) due to a history of hereditary spherocytosis. Parvovirus B19 is a single stranded DNA virus that has various clinical presentations in infected humans. The most recognizable presentation of parvovirus is erythema infectiosum (Fifth disease). Fifth disease presents with the characteristic slapped cheeks appearance. Individuals with a history of sickle cell disease, HIV, iron deficiency anemia, or hereditary spherocytosis are at increased risk of developing aplastic crisis which results in a decreased RBC production causing anemia only. In contrast, aplastic anemia results in pancytopenia. Figure A demonstrates the characteristic "slapped cheeks" appearance of parvovirus B19 infection. Incorrect Answers: Answer 1: Vitamin D deficiency is associated with anemia in chronic kidney disease, but not with aplastic anemia. Answer 2: HgA2 levels are typically increased in beta-thalassemia minor. Answer 3: Sickle cell disease would present with high levels of HbS. Answer 4: HIV co-infection with parvovirus is unlikely in this patient as he has been healthy up to this point.
4.3
(6)
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