Pure Red-Cell Aplasia of 10 Years' Duration Due to Persistent Parvovirus B19 Infection and Its Cure with Immunoglobulin Therapy

PARVOVIRUS B19 is the etiologic agent of transient aplastic crisis, an acute episode of bone marrow failure in persons with underlying hemolysis.1 , 2 In tissue-culture studies, parvovirus B19 infects3 and replicates4 in erythroid progenitor cells. The pathophysiologic basis of acute marrow failure in patients is viral tropism and cytotoxicity for erythroid progenitor cells.5 , 6 In experimental7 and natural8 infections, the infection is terminated with the development of specific antibodies, which neutralize the activity of the virus in vitro.9 In the immunocompromised host who is unable to produce neutralizing antibody,10 an infection with parvovirus B19 can persist and cause chronic bone marrow failure, . . .