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Hereditary Spherocytosis — RACP Adult Medicine MCQ

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HardHaematologyHereditary SpherocytosisRACP Adult Medicine

A patient with hereditary spherocytosis develops abrupt severe anaemia, very low reticulocytes and fever after contact with a child with a viral rash. What is the most likely complication?

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Correct answer: E — Parvovirus B19 aplastic crisis causing transient erythroid marrow suppression

The best answer is “Parvovirus B19 aplastic crisis causing transient erythroid marrow suppression”. Parvovirus B19 temporarily suppresses erythropoiesis; in chronic haemolysis this causes profound anaemia with reticulocytopenia, unlike a haemolytic crisis in which reticulocytes rise. Supportive transfusion may be required, infection precautions matter for pregnant contacts, and persistent infection is considered in immunocompromised patients.

Reference: Royal Children's Hospital Melbourne: Anaemia clinical guideline: https://www.rch.org.au/clinicalguide/guideline_index/Anaemia/