The Ghost of Parvovirus Past: Idiopathic Pure Red Cell Aplasia
Responding to IVIG Following Resolved Perinatal Parvovirus B19 Infection
Abstract
Pure red cell aplasia (PRCA) is characterized by isolated anemia and a
marked reduction or absence of erythroid precursors in the bone marrow.
Depending on the underlying etiology, treatment may include
immunomodulation or cytotoxic agents, chronic red blood cell
transfusions, or hematopoietic stem cell transplantation. Parvovirus B19
infection is a well-recognized cause of transient PRCA, typically
resolving with viral clearance. We report an unusual late relapse of
PRCA occurring years after parvovirus B19 eradication, unresponsive to
steroids and mycophenolate mofetil. Remarkably, prolonged treatment with
intravenous immune globulin (IVIG) resulted in complete remission,
highlighting its therapeutic utility for idiopathic PRCA.