A 5 year-old girl with Hb SC disease and TAC due to parvovirus B19 infection was symptomatic with Hb 5.1 gm/dL and received a red cell transfusion; her parents had resisted transfusion for some time. Two asymptomatic siblings with Hb SC disease were tested and had evidence of early TAC; each child's Hb level had fallen 2.6 gm/dL below baseline with reticulocytopenia. In an effort to shorten the duration of TAC and reduce the likelihood of blood transfusion, each sibling was given a single infusion of 400 mg/kg IVIG. Both siblings remained asymptomatic and recovered without transfusion. As expected, sibling 2 had evidence of acute parvovirus B19 infection; sibling 1's serum is not yet tested. We speculate that IVIG administration resulted in clearing of parvoviremia, with accelerated recovery of erythropoiesis and avoidance of transfusion. While a randomized controlled study of IVIG administration to high risk susceptible household contacts is needed to clarify the role of IVIG in this setting, early screening of household and, perhaps, hospital contacts at risk for TAC might be considered. This may permit early treatment of TAC with IVIG and reduce the likelihood of severe anemia and blood transfusion. Table

Table 1 No caption available.
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