Ukrainian Journal of Perinatology and Pediatrics. 2025.3(103): 183-190. doi: 10.15574/PP.2025.3(103).183190
Mateiko H. B., Horbal N. B., Ivanenko A. L., Zubyk B. A., Pyliuk I. I.
Ivano-Frankivsk National Medical University, Ukraine

For citation: Mateiko HB, Horbal NB, Ivanenko AL, Zubyk BA, Pyliuk II. (2025). Severe thrombocytopenia and anemia in a child with parvovirus B19 infection (a case report). Ukrainian Journal of Perinatology and Pediatrics. 3(103): 183-190. doi: 10.15574/PP.2025.3(103).183190.
Article received: Apr 03, 2025. Accepted for publication: Sep 15, 2025.

Parvovirus B19 (PVB19) is a common viral pathogen associated with various hematological disorders, particularly in pediatric patients. This case report highlights a rare presentation of severe thrombocytopenia and anemia in an immunocompetent child after PVB19 infection.
Aim – based on a clinical case, analyze the course of severe thrombocytopenia and anemia in a child with parvovirus infection to raise awareness among physicians about hematological complications associated with PVB19.
Clinical case of severe thrombocytopenia in a 3-month-old Ukrainian boy. The disease began with the appearance of a petechial rash after a mild respiratory illness. Before the boy's illness, his two siblings were diagnosed with PVB19 infection. The child had persistent thrombocytopenia and anemia. In blood PVB19 DNA was revealed, positive immunoglobulin (Ig) G to PVB19 was detected. The child received platelet concentrate transfusions, pulse therapy with prednisolone, and immunoglobulin. There was no stable response to treatment. No immunodeficiency or systemic hematological disease was detected. No genetic predictors of anemia were identified. The final diagnosis was established: Acute parvovirus infection, severe course. Acute thrombocytopenic purpura. Anemia of complex genesis, severe form. Complications: Hypofibrinogenemia. The child was discharged home on day 72 with normal levels of thrombocytes and hemoglobin.
Conclusion. Hematological complications determine the severity of the course and prognosis of PVB19 infection. For these reasons, in young children, considering the likelihood of thrombocytopenia and anemia, for timely diagnosis, it is recommended to determine IgM to PVB19 and verify the diagnosis of PVB19 infection. Severe hematological complications, in particular, transient aplastic crisis, develop after 3-4 weeks, so it is essential to monitor the indicators of a complete blood count in children after PVB19 infection.
The study was conducted according to the principles of the Declaration of Helsinki. Parents’ agreement has been received for it.
The authors declare no conflict of interest.
Keywords: thrombocytopenia, anemia, parvovirus B19 infection, infectious erythema, children.

REFERENCES

1. Algwaiz, G, Alharbi A, Alsehaim K, Alahmari A, El Fakih R, Aljurf M. 2023. Hematologic Manifestations of Parvovirus B19 Infection. Hematol Oncol Stem Cell Ther. 16(4): 316-322. https://doi.org/10.56875/2589-0646.1031; PMid:37363985

2. Anderson MJ, Higging PG, Davis LR et al. (1985). Experimental parvovirus infection in humans. Journal of Infectious Diseases. 152: 257-265. https://doi.org/10.1093/infdis/152.2.257; PMid:2993431

3. Bloise S, Cocchi E, Mambelli L, Radice C, Marchetti F. (2024). Parvovirus B19 infection in children: a comprehensive review of clinical manifestations and management. Ital J Pediatr. 50(1): 261. https://doi.org/10.1186/s13052-024-01831-6; PMid:39696462 PMCid:PMC11657867

4. Donato H. (2021). Neonatal thrombocytopenia: A review. I. Definitions, differential diagnosis, causes, immune thrombocytopenia. Arch Argent Pediatr. 119(3): e202-e214. https://doi.org/10.5546/aap.2021.eng.e202

5. Eid AJ, Brown RA, Patel R, Razonable RR. (2006, Jul 1). Parvovirus B19 infection after transplantation: a review of 98 cases. Clinical Infectious Diseases. 43(1): 40-48. https://doi.org/10.1086/504812; PMid:16758416

6. Katilov O V, Bulat L M, Laiko L I, Lobodiuk A O. (2023). Infektsiini (virusni) ekzantemy v praktytsi pediatra. Dytiachyi likar. 85(4): 22-32.

7. Kerr JR. (2015). A review of blood diseases and cytopenias associated with human parvovirus B19 infection. Rev Med Virol. 25(4): 224-40. Epub 2015 May 11. https://doi.org/10.1002/rmv.1839; PMid:25962796

8. Kopcha VS. (2024). Infektsiia, zumovlena parvovirusom B19, u vahitnykh. Klinichna imunolohiia. Alerholohiia. Infektolohiia, 153(4): 28-33.

9. Lembryk IS, D.H., Zhyliak OV, Tsytsiura OO, Kostyrko NI. (2023). Erythema infectiosum and Raynaud's phenomenon in a child after a coronavirus disease: description of a clinical case. Ukrainian Journal of Perinatology and Pediatrics. 96(4): 145-150. https://doi.org/10.15574/PP.2023.96.145

10. Potter CG, Potter AC, Hatton CSR et al. (1987). Variation of erythroid and myeloid precursors in the marrow and peripheral blood of volunteer subjects infected with human parvovirus B19. Journal of Clinical Investigation. 79: 1486-1492. https://doi.org/10.1172/JCI112978; PMid:3033026 PMCid:PMC424424

11. Provan D, Arnold DM, Bussel JB, Chong BH, Cooper N, Gernsheimer T et al. (2019). Updated international consensus report on the investigation and management of primary immune thrombocytopenia. Blood Adv. 3(22): 3780-3817. https://doi.org/10.1182/bloodadvances.2019000812; PMid:31770441 PMCid:PMC6880896

12. Rasizadeh R, Ebrahimi F, Zamani Kermanshahi A, Daei Sorkhabi A, Sarkesh A et al. (2024). Viruses and thrombocytopenia. Heliyon. 10(6): e27844. https://doi.org/10.1016/j.heliyon.2024.e27844; PMid:38524607 PMCid:PMC10957440

13. Thakur Y, Meshram RJ, Taksande A. (2024). Diagnosis and Management of Immune Thrombocytopenia in Paediatrics: A Comprehensive Review. Cureus. 16(9): e69635. PMID: 39429356; PMCID: PMC11488990. https://doi.org/10.7759/cureus.69635