1265row showed erythrobastopenia (less than 1% of erythroblasts). The presence of serum anti-HPV IgM (radioimmunoassay) suggested a recent HPV infection. Packed red cells (600 ml) were transfused. Over the next few days the symptoms disappeared and haemoglobin concentrations remained stable. Ten days after admission reticulocyte count was 150 x 109/1. Eighteen months later, the patient was quite well and all haematological investigations yielded normal results blood count, haemoglobin electrophoresis, erythrocytic enzymes (glucose-6-phosphate-deshydrogenase, glucose-phosphogluconate-deshydrogenase, hexokinase, glucose-isomerase-phosphate, glucose-pyruvate, glutathione reductase, acetyl-cholinesterase, pyrimidine-5'-nucleotidase), osmotic resistance and autohaemolysis.Our observation of HPV infection associated with aplastic crisis but without haemolysis differs from the transient erythroblastopenia seen in childhood, which often affects younger children (1 to 4 years) and occurs without HPV infection.3Aplastic crisis associated with HPV infection has hitherto only been described in hereditary2 4-6 or acquired' haemolytic anaemias. It seems that the erythroblastopenic effect of HPV is constant but goes unnoticed if the red cell life span is normal. A shortened red cell survival (haemolysis) is necessary to cause acute anaemia. Acute anaemia occurring without haemolysis due to an HPV infection is difficult to explain. In our patient only isotopic labelling of his erythrocytes could have completely excluded underlying haemolysis. Nonetheless, we wanted to record the experience to encourage doctors to ask for parvovirus serology in similar clinical circumstances.

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