Sickle Cell Aplastic Crisis

Aplastic crisis is transient suppression of erythropoiesis, classically from parvovirus B19, in a child dependent on high baseline marrow red cell production because of chronic haemolysis.

• Sudden severe pallor
• Fatigue
• Tachycardia
• Weakness
• Sometimes fever or viral prodrome

Splenomegaly is not the defining feature, unlike sequestration.

• Significant fall in haemoglobin.

• Reticulocytopenia is the key finding.

• Parvovirus B19 PCR or IgM may confirm infection.

• Supportive care.

• Transfuse packed red cells when anaemia is severe or symptomatic.

• Marrow recovery generally occurs spontaneously within approximately 7 to 10 days.

• Immunocompromised children with persistent parvovirus infection may require IV immunoglobulin under specialist care.