Polymerase chain reaction of archival material for parvovirus B19 in children with transient erythroblastopenia of childhood

The association of transient erythroblastopenia of childhood (TEC) and parvovirus B19 (B19) infection has been debated. Large series, chiefly using serologic evaluation, have not shown an association, whereas smaller series have. Using the polynierase chain reaction (PCR) we attempted to detect B19 DNA extracted from archived bone marrow coverslips of 16 patients diagnosed with TEC. The patients ranged from 3 to 23 months old, with a mean hemoglobin of 5.4 g/dL. Sixty-nine percent were neutropenic and none was thrombocytopenic. None of the patients' bone marrows had histologie evidence of B19 infection, and DNA amplification for B19 was negative in each case. In contrast, B19 was amplified from DNA isolated from archived bone marrow coverslips of a patient with known B19 infection, indicating that the PCR assay was sufficiently sensitive to detect virus from archived bone marrow. Review of the literature indicates that the patients with "parvovirus B19-associated TEC" are older and present with anemia and thrombocytopenia; patients with B19-negative TEC are young children with anemia and no thrombocytopenia, similar to the patients in our study. We propose that B19 is not the cause of anemia in the young patient with typical features of TEC and that its occurrence in older previously healthy children is simply a manifestation of the viral infection not typically recognized.