PMC9941661_01
Timeline depicting the disease course of the patient. The timeline illustrates the different events in the course of the patient's treatment and disease progression.
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Two months later, her condition changed, and she experienced repeated reductions in hemoglobin (60 g/L, reference range 130-170 g/L) and reticulocytes (0.001x1012/L, 0.1%) ( Figure 1 ).
Bone marrow smear of the patient. (A) Hemophagocytic cells and proerythrocytes infected by parvovirus B19. Red arrows indicated hemophagocytic cells, blue arrows indicated proerythroblasts, and yellow arrows indicated viral inclusion bodies. (B) Hemophagocytic cells underwent phagocytosis.
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The bone marrow smear revealed many giant proerythroblasts ( Figure 2A ) and erythroid maturation arrest. PCR revealed that the viral load was 1.4x1010 copy/mL (range, 0-103 copy/mL). Patient found to have increased ferritin (3865 ng/mL, reference range 7-323 ng/mL), triglycerides (4.6 mmol/L, reference range 0.3-1.7 mmol/L), reduced fibrinogen (0.83 g/L, reference range 2.0-4.0 g/L), elevated body temperature (38.5 C) for ten days, hemophagocytic cells in the bone marrow smears ( Figures 2A, B ), enlarged spleen, and cytopenia.
Results of next-generation sequencing in the peripheral blood. Mapping results of nucleotide sequences distributed along the genome of parvovirus B19 in the peripheral blood to parvovirus B19 reference genome NC_000883.
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