Autoimmune Hemolytic Anemia Triggered by Infection with Human Parvovirus B19 after Total Abdominal Colectomy for Ulcerative Colitis

Abstract

A 50-year-old man was admitted to our hospital for an adhesive ileus 14 years after total abdominal colectomy for ulcerative colitis (UC). The ileus decreased with conservative treatment, however, autoimmune hemolytic anemia (AIHA) was diagnosed due to worsening anemia, a positive direct Coombs test, low haptoglobin, high lactase dehydrogenase, reticulocytosis, and an increase in the erythroblastic series in a bonemarrow examination. Human parvovirus B19 (PV-B19) IgM and PV-B19 DNA were present, indicating the development of AIHA triggered by an infection with PV-B19. The patient is currently being monitored after spontaneous remission. This is the first report of UC after total abdominal colectomy complicated by AIHA triggered by PV-B19 infection.

Acute Exacerbation of Anemia with Parvovirus B19 Infection One Year after Sleeve Gastrectomy for Severe Obesity

“…One explanation for the rapid progression of anemia in our patient might be that acute infection with parvovirus B19 caused transient hemolysis and hematopoietic disorders. Some case reports suggest that parvovirus B19 infection causes autoimmune hemolytic anemia ( 23 - 25 ); however, we were unable to demonstrate the presence of this type of anemia in our patient because the direct Coombs test was negative. Since we did not find any erythrocytes expressing CD55 (-) or CD59 (-), paroxysmal nocturnal hemoglobinuria was also considered an unlikely diagnosis.…”