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Why can a respiratory infection trigger a severe anemia episode in hereditary spherocytosis?
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blood disease
Peripheral blood smear revealing histopathologic features indicative of a blast crisis in a case of chronic myelogenous leukemia (CML). Blast crisis occurs when one-fifth to one-third of the cells in the blood or bone marrow are immature blood cells, or blast cells. This phase of CML is characterized by fever, weakness, and an enlarged spleen.
In hereditary spherocytosis, patients typically experience a chronic, mild anemia because their red blood cells are structurally fragile and have a shortened lifespan, requiring the bone marrow to produce new cells at an accelerated rate to compensate for this constant destruction.12
A respiratory infection can trigger a severe episode of anemia, known as an aplastic crisis, by briefly suppressing this necessary, accelerated production of red blood cells. Specifically, viruses such as parvovirus are known to cause this transient cessation of erythropoiesis. Because the bone marrow stops replenishing the blood supply while the underlying destruction of fragile cells continues, the patient’s hemoglobin levels can drop precipitously.2