A 30-year-old woman with HbSS presents with Hb 4.8 g/dL (baseline 8.0), reticulocyte count 0.2%, and fever. What is the most likely diagnosis and appropriate management?
- A Acute chest syndrome; exchange transfusion
- B Splenic sequestration; exchange transfusion
- C Aplastic crisis due to parvovirus B19; simple transfusion and isolation ✓
- D Hyperhemolytic crisis; IVIG and steroids
Correct answer: C. Aplastic crisis due to parvovirus B19; simple transfusion and isolation
Explanation
Reticulocytopenia with severe anemia in sickle cell disease indicates aplastic crisis, most commonly from parvovirus B19 infection which temporarily suppresses erythropoiesis. Management is supportive with simple transfusion. Droplet isolation is required because parvovirus B19 is contagious. Splenic sequestration shows reticulocytosis and a tender spleen. Exchange transfusion is reserved for acute chest syndrome or stroke.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.