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NBME 21 Answers

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A 24-year-old woman with sickle cell disease comes ...

Serum parvovirus B19 IgM antibody test

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submitted by jo(6),

Parvo infects RBC precursors in the marrow which can cause aplastic crisis in sickle cell patients.

jo  Infection of precursors halt RBC maturation which leads to giant pronormoblasts with intranuclear viral inclusions in the periphery (UWorld) +1  

 +2  upvote downvote
submitted by temmy(22),

Healthy people who get sick with parvovirus may have a subclinical illness with athralgias as the only symptom. But sickle cell patients and patients with decreases hematopoiesis will develop[ bone marrow failure because the virus affect the hematopoietic stem cells leading to aplastic crises and inability for the bone marrow to adequately compensate hence the low reticulocyte count. parvovirus causes..slapped cheeks in kids hydrops fetalis in fetus, aplastic crises in sickle cell and arthralgias in other patients.

henoch280  thanks. very helpful +