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544 Part VI: The Erythrocyte Chapter 36: Pure Red Cell Aplasia 545

18 200 Figure 36–2. Diagram of the clinical course of a
HIV-1–infected patient with red cell aplasia caused
IgG IgG 123
PRBC by B19 persistent parvovirus. Note the increase of
the reticulocyte count (open circles) to the first infu-
150 sion of immunoglobulin (Ig) G (hatched bar) and the
12 µ subsequent decline in parvovirus titers. Thereafter,
the reticulocyte count and the hemoglobin (Hgb)
Hb (g/dL) Hb 100 Reticulocytes (1000/ L) concentration (closed circles) decrease, reflecting
the return of the anemia. A second IgG treatment
increases the reticulocyte count and Hgb concen-
6 tration and decreases the parvovirus titers. PRBC,
packed red blood cells.
50

Reticulocytes
0 0
12

B19 genome copies/mL serum 10 6
10

10 0
5/3/89 6/2/89 7/2/89 8/1/89 8/31/89 9/30/89 10/30/89
Date

responsive to immunoglobulin infusions likely represent treatment of 19. Boria I, Quarello P, Avondo F, et al: A new database for ribosomal protein genes which
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