PARVO B19 Virus (Marilyn)

Parvo B19 Virus (Slap Cheek or 5th Disease) has the ability to shut down Red Cell production in the bone marrow.  Though less likely to impact normal healthy people.  It may be more of a danger to those dealing with other negative health issues.

In a normal otherwise healthy patient, ending up with a Red Cell Production Shut Down.  While possible it would be rare.  In fact normal healthy people might not even think much about some minor symptoms of a low fever and rosy red cheeks. Or “Slap Cheek”, which is a common term for Parvo B19.

The Red Cell Production shut down condition may be transient in nature.  Lasting a week to 10 days.  The chance Red Cell production never starts back up, is a possibility though.

In a CADs case where they are dealing constantly with Hemolytic Anemia.  Where they typically have Red Cell destruction going on.  But at the same time an above normal to high Retic Rate.   Retic is the rate at which the bone marrow is creating new replacement Red Cells.

So if destruction is going on, and Retic is high.  These two factors may play a balancing act  that may be considered “Normal” for a CAD.  That condition falls in the category of Hemolytic Anemia.  If the COD patient has kept warm and things as far a RBC remain constant, health and test indicators may remain constant.  This balanced level as indicated, might be considered the “CAD Normal” range for the individual CAD.   That may vary from CAD to CAD.

When a CAD starts into a crisis of a falling Red Cell count, especially when this seems accelerated over a very short time frame.  Destruction and Retic need to be re-evaluated.

Excessive Cold exposures would obviously be the first suspect.  Accelerating Red Cell Destruction due to CAD beyond the Retic ability of the patient.

But what is If there hasn’t been above normal  cold exposures to overly activate CAD?

Where Destruction has not accelerated.  But Retic rate has fallen to below normal, or has completely shut down.

You/your medical team may have to then suspect something that is now impacting your Retic rate.

Viruses might be a prime suspect in this latter scenario.

Parvo B19 virus is one that can have a serious impact on a CAD patient.  It does have the potential to cause the bone marrow to completely shut down Red Cell Production.  This creates a secondary Anemic condition that is categorized as Aplastic Anemia.

There are specific IgM and IgG anti-B19 antibodies that would test positive (ELISA)

If indeed your accelerated Red Blood Count (RBC) droppage is due to the Parvo virus, it may run its course and in the process shut down Red Cell production.  That shut down typically lasts a week to ten days.

During this “RBC production shut down” time frame, especially in a CAD who’s own immune system is already destroying Red Cells.  It may be impossible for the patient to ride this out unassisted.  Blood Transfusions more than likely would be required to maintain safe levels of red blood cells in the body.

In some cases Procrit can/is given to help stimulate red cell production and or help trigger startup.

Then hopefully the body will start “Retic’ing” around a week to ten days.  After the Parvo virus runs its course.

Additional Notes

Procrit can/is given to help stimulate red cell production startup.

Transfusions given to bridge the anemic period when no Red Cell Production is happening.

Should only get Parvo B19 once in a lifetime.  Antibodies should be created naturally once your body fights it.

There are specific antibodies to test for.  IgM & IgG anti-B19

Marilyn had it a second time.  The 2nd bout was 5 years after the first event.  Rituxan treatment was in between.  Rituxan was suspected of stripping her antibodies.  During both events she experienced complete shut down of Red Blood Cell production.

IVIG infusions were used (after 2nd bout with Parvo) in an attempt to restore other possible missing antibodies that Rituxan may have stripped away.  She had a vast improvement after IVIG as far as not getting every cold that was passed around.

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