Rosales MGF, Hernández MPG, Íñiguez ÁKP, Martínez RVL, León AA

Language: Spanish
References: 14
Page: 65-67
PDF size: 129.30 Kb.

ABSTRACT

Fever of unknown origin is a clinical challenge when it is associated with trisomy 21. Presentation of a case of male 19 years old, from Mexicali, Baja California, with trisomy 21, multiple blood transfusions, hepatitis b and chronic anemia. Four months of evolution with fever of 38.5 °C, does not controled with antipyretics or physical means, without a predominance of schedule, sporadic, without another symptom. Treated with diferents antibiotics without improvement. He was hospitalized for study. At physical examination, with pallor, persistent fever, no visceral growths. Initial hemogram: hemoglobin 7.10g/dL, hematocrit of 23.60%, leukocytes 11 074 cells/mm³, lymphocytes 70%, platelets 445 000/mm³, blood cultures without bacterial development, liver function tests and image studies without alterations. Serology for cytomegalovirus, Epstein-Barr and quantiferon Tb Gold, negative, bone marrow aspirate with hyperreactive, bone marrowculture without bacterial growth. Parvovirus B19 IgM serology positive. It was treated with gamma globulin; fever was relieved, and hemoglobin levels improved. discussion. diagnosis of parvovirus B19 (PVB19) infection was made by exclusion, persistent fever and chronic anemia gave rise to a suspected diagnosis. In trisomy 21, due to immunological alterations there is greater susceptibility to infections and development of leukemia, in controlled studies it has been seen that pvb19 generates predisposition to leukemia.

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