Which patients are at risk for aplastic crisis with erythema infectiosum (fifth disease)?

Updated: Mar 06, 2020
  • Author: Glenn L Zellman, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Human PV-B19 infects erythroid cells, causing a reticulocytopenia that lasts 7-10 days. A healthy host experiences no consequences, since the normal life span of an RBC is 120 days. In patients with a background of shortened RBC survival, such as hemolytic anemia, an acute aplastic crisis ensues. At-risk patients include those with any of the following conditions:

  • Sickle cell anemia

  • Hereditary spherocytosis

  • Thalassemia

  • Glucose-6-phosphate dehydrogenase deficiency

  • Pyruvate kinase deficiency

  • Autoimmune hemolytic anemia

The incidence of human PV-B19–induced aplastic crisis in patients with chronic hemolytic anemia is 2-5% per year. Patients with aplastic crisis continue to be viremic and infectious until RBC recovery occurs.


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