Acute Exacerbation of Anemia with Parvovirus B19 Infection One Year after Sleeve Gastrectomy for Severe Obesity

Toshimitsu Shinzawa; Isao Usui; Kanako Hanawa; Hayato Kajitani; Shintaro Sakurai; Takuya Tomaru; Toshie Iijima; Teruo Jojima; Kazuyuki Kojima; Yoshimasa Aso

doi:10.2169/internalmedicine.8446-21

CASE REPORTS

Acute Exacerbation of Anemia with Parvovirus B19 Infection One Year after Sleeve Gastrectomy for Severe Obesity

Toshimitsu Shinzawa, Isao Usui, Kanako Hanawa, Hayato Kajitani, Shintaro Sakurai, Takuya Tomaru, Toshie Iijima, Teruo Jojima, Kazuyuki Kojima, Yoshimasa Aso

Author information

Toshimitsu Shinzawa
Department of Endocrinology and Metabolism, Dokkyo Medical University, Japan
Isao Usui
Department of Endocrinology and Metabolism, Dokkyo Medical University, Japan
Kanako Hanawa
Department of Endocrinology and Metabolism, Dokkyo Medical University, Japan
Hayato Kajitani
Department of Endocrinology and Metabolism, Dokkyo Medical University, Japan
Shintaro Sakurai
Department of Endocrinology and Metabolism, Dokkyo Medical University, Japan
Takuya Tomaru
Department of Endocrinology and Metabolism, Dokkyo Medical University, Japan
Toshie Iijima
Department of Endocrinology and Metabolism, Dokkyo Medical University, Japan
Teruo Jojima
Department of Endocrinology and Metabolism, Dokkyo Medical University, Japan
Kazuyuki Kojima
First Department of Surgery, Dokkyo Medical University, Japan
Yoshimasa Aso
Department of Endocrinology and Metabolism, Dokkyo Medical University, Japan

Keywords: sleeve gastrectomy, parvovirus B19, hemolytic anemia, pancytopenia, severe obesity

JOURNAL OPEN ACCESS

2022 Volume 61 Issue 17 Pages 2631-2635

DOI https://doi.org/10.2169/internalmedicine.8446-21

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Abstract

Pancytopenia due to malnutrition sometimes occurs after gastric bypass but is rare after sleeve gastrectomy. A 35-year-old patient underwent sleeve gastrectomy for severe obesity. Twelve months after the operation, rapid progression of macrocytic anemia with leukopenia and thrombocytopenia occurred, and a decrease in some vitamins and trace elements due to an insufficient food intake was also detected. Haptoglobin decreased, suggesting the presence of hemolysis. In addition, IgM antibody against parvovirus B19 was detected, followed by IgG antibody. Parvovirus B19 infection was suggested to be involved in the rapid progression of anemia in this malnourished patient after bariatric surgery.

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