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Biomedical subjects

S J Naides

Publications and source records attributed to S J Naides.

At least 37 records · Page 2Linked to original sources
PubMed1993

Parvovirus B19 infection in human immunodeficiency virus type 1-infected persons failing or intolerant to zidovudine therapy.

To determine the incidence of B19 infection in patients with AIDS who were being treated with dideoxyinosine, serial sera (n = 28) taken over a 2-year period from 14 individuals were analyzed with respect to anti-B19 serology and the presence of B19 DNA. All 14 individuals were anti-B19 IgM negative. Nine of 14 had B19 viremia by Southern analysis of polymerase chain reaction product. Five of 9 with B19 viremia had > or = 1 anti-B19 IgG-positive sample; none of 5 without viremia had anti-B19 IgG. Four of 9 viremic individuals had serially positive samples. All 4 had severe anemia (hemoglobin < 8.5 g/dL) while taking zidovudine. A fifth individual whose severe anemia resolved after zidovudine was discontinued did not have B19 viremia. Therefore, a significant proportion of this group of patients with AIDS who developed severe anemia while receiving zidovudine had persistent B19 infection. These results suggest that B19 infection should be considered in anemic patients with AIDS.

AIDS-Related Opportunistic Infections↗
PubMed1993

Viral infection including HIV and AIDS.

Viruses have long been considered candidates for infectious etiologic agents or cofactors in the development of rheumatic diseases. The current epidemic of HIV infection has focused both scientific and lay interest on identifying such agents and understanding their role in precipitating and perpetuating disease. During 1992, the role of hepatitis C virus infection in cryoglobulinemia was further defined. Interest in members of the Herpesviridae family was raised. The potential for postvaccination rubella arthritis was popularized. Additional clinical presentations of parvovirus B19 infection were described. Studies in patients and in vitro continued to provide tantalizing clues to the possible role of retroviruses, both exogenous and endogenous, in rheumatic disease. This review highlights efforts made during the past year to elucidate the role of viral infection in rheumatologic disease.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Established fibromyalgia syndrome and parvovirus B19 infection.

OBJECTIVE: To determine the seroprevalence of prior and persistent parvovirus B19 (B19) infection in a group of patients with fibromyalgia (FS) compared with controls. METHODS: Fifteen female patients with FS who recalled a viral prodrome (+VP) preceding the onset of FS symptoms and eleven patients with FS who did not recall any such illness (-VP) were selected from a referral practice. We excluded patients with FS who described a history of trauma prior to the onset of FS symptoms. Twenty-six female medical workers served as controls. Serum IgM and IgG anti-B19 antibodies were measured by ELISA: Polymerase chain reaction (PCR) products from serum were analyzed by dot blot hybridization for B19 DNA. Fisher's 2-tailed exact test was used to compare the proportion of positive serologies in each group. RESULTS: No patient or control had positive IgM levels. For all patients with FS, the prevalence of prior B19 infection was comparable to that of healthy controls (11/26 vs 12/26, p = 1.00) and that of the general population. No significant difference was found in the prevalence of prior B19 infection in FS + VP and FS-VP patients (8/15 vs 3/11, p = 0.25). None of the patients or controls showed evidence for persistent B19 viremia, as determined by PCR analysis. CONCLUSION: Our data do not suggest that B19 plays a pathogenic role in this population of patients with FS. Testing for IgM against B19 within 2-3 months of symptom onset may prove more helpful in further defining the role of B19 in FS.

Adult↗
PubMed1993

Parvovirus B19 infection.

Human parvovirus B19 is a recently discovered and characterized DNA virus. B19 infection in the community is common and widespread. A number of well-known clinical syndromes have now been ascribed to B19 infection. Of rheumatologic interest, B19 infection causes adult erythema infectiosum which may be associated with a rheumatoid-like syndrome of symmetric polyarthralgia and polyarthritis. Presenting symptoms and signs may be limited to the joints. Some adults develop a chronic arthropathy that needs to be differentiated from early classic rheumatoid arthritis. Evidence for persistent B19 infection suggests that human parvovirus B19 infection may serve as a model for the study of virus-host interactions and the role of viruses in the pathogenesis of rheumatic diseases.

Arthritis, Infectious↗
PubMed1992

A combined pseudoreplica-immunochemical technique for research and diagnostic virology.

Pseudoreplica and immunochemical techniques were combined in a single protocol for identification of virus in research and clinical specimens. Stock preparations of vesicular stomatitis virus (VSV), cytomegalovirus (CMV), and herpes simplex virus (HSV) were used to develop the technique. Traditional pseudoreplicas of viral stock solutions were prepared but not negatively stained. The virus was then immunolabeled in two stages. Virus-specific polyclonal antisera were used in the first stage; colloidal gold conjugated antibodies were used as indicator antibody in the second stage. After immunolabeling, the grids were negatively stained. As a demonstration of the clinical usefulness of this approach, it was employed to antenatally identify human parvovirus B19 particles in ascites from a 22 week gestational fetus with nonimmune hydrops fetalis. The combined pseudoreplica-immunochemical approach offers several advantages over both the pseudoreplica and immunochemical methods when used in isolation. Advantages include relative purification of samples, concentration of virus, morphological preservation, and enhanced diagnostic specificity.

Cytomegalovirus↗
PubMed1992

Subcutaneous pancreatic fat necrosis associated with acute arthritis.

Subcutaneous fat necrosis is a well described, rare sequela of acute pancreatitis. Uncommonly, arthritis is seen in association with these 2 disease processes. We report a case of fulminant pancreatitis presenting as an acute arthritis. Birefringent crystal-like structures led to initial diagnostic confusion with gout.

Acute Disease↗
PubMed1991

Fibromyalgia and parvovirus infection.

An infectious cause of fibromyalgia (FM) has been hypothesized based upon the observed similarity of this entity and chronic fatigue syndrome. Three patients developed symptoms of FM after documented episodes of acute parvovirus B19 infections. B19 antibody determinations were obtained approximately 1 month after the symptoms began; both IgM and IgG titers were positive at that time. All 3 patients met criteria for FM. Polysomnography performed on 2 of the patients revealed profound alpha-wave intrusion throughout nonrapid eye movement sleep. A more careful search for viral infections in FM patients whose symptoms appear following a "flu-like" illness appears warranted.

Adult↗
PubMed1990

Rheumatologic manifestations of human parvovirus B19 infection in adults. Initial two-year clinical experience.

During 1987 and 1988, we identified 9 adults at the Medical and Rheumatology Services of the University of Iowa Hospitals and Clinics who had a clinical diagnosis of fifth disease; 8 of the 9 had symptoms of joint involvement. Another 12 adults with serologic positivity for anti-parvovirus B19 IgM antibody presented with polyarthralgia/polyarthritis. Patients were usually found to be seronegative for rheumatoid factor, and none developed nodules or erosive disease. Many patients with chronic disease met criteria for a diagnosis of rheumatoid arthritis. A diagnosis of parvovirus B19 infection should be considered during the initial visit of patients with polyarthralgia/polyarthritis.

Adult↗
PubMed1989

Human parvovirus B19 infection among hospital staff members after contact with infected patients.

In the spring and summer of 1988, two separate outbreaks of an illness with a rash resembling erythema infectiosum occurred among members of the nursing staff of the Children's Hospital of Philadelphia. The sources were two adolescent patients with sickle cell disease and aplastic crisis who had unsuspected parvovirus infection. Tests for IgM and IgG antibodies to parvovirus B19 were positive in both patients, and electron microscopical examination showed parvovirus-like particles in the early serum samples. Of 40 health care workers exposed to infected patients, 12 (30 percent) were infected, 2 (5 percent) were possibly infected, 8 (20 percent) had evidence of a past infection with B19, and 18 (45 percent) remained seronegative. Attack rates among the susceptible contacts were 36 percent in the first outbreak and at least 38 percent in the second. Clinical symptoms began a mean of 12.6 days after exposure and included malaise, rash, and joint pain. We conclude that hospital workers are at risk of contracting nosocomial erythema infectiosum from patients with parvovirus-associated aplastic crisis. We recommend that all patients with hereditary hemolytic anemias who are admitted with a febrile illness be evaluated for aplasia and promptly placed in respiratory and contact isolation if aplastic crisis is suspected.

Adolescent↗
PubMed1989

Antenatal diagnosis and palliative treatment of non-immune hydrops fetalis secondary to fetal parvovirus B19 infection.

Hydrops fetalis was diagnosed at 22 weeks. An ultrasound examination demonstrated cardiomegaly and a fetal blood specimen obtained by cordocentesis revealed thrombocytopenia, anaemia, and neutropenia. Fetal paracentesis yielded straw-coloured fluid with electrolytes indicative of a transudate. Non-enveloped icosahedral viral particles approximately 23 mm in diameter were visualized in the ascitic fluid by electron microscopy. Immune electron microscopy confirmed human parvovirus B19. Direct fetal digitalization led to a reduction in umbilical artery resistance, a decline in the abdominal circumference from 20.3 to 17.8 cm, and resolution of the ascites within 72 h. Despite this dramatic response to therapy, fetal death occurred on day 5 of treatment. The initial maternal serum was positive for anti-B19 IgM and IgG antibodies. Electron microscopy of fetal cardiac tissue obtained post-mortem revealed intranuclear viral particles typical of B19, confirming the antenatal diagnosis of myocarditis. This case demonstrates that direct viral identification is applicable to prenatal diagnosis. To our knowledge, this is the first reported case of the antenatal diagnosis and palliative treatment of fetal viral infection.

Adult↗
PubMed1989

Human parvovirus infection.

Fifth disease (erythema infectiosum) has recently been linked to human parvovirus (HPV) infection. HPV is also capable of causing aplastic anemia, arthritis and perinatal complications, including hydrops fetalis and spontaneous abortion. Clinically suspected cases of HPV infection can now be confirmed serologically. IgM antibodies peak early in the course of infection and are usually undetectable by two months. New procedures, including HPV-specific DNA probes, are being used to confirm in utero infections.

Anemia, Aplastic↗
PubMed1989

Parvovirus B19 infection in patients receiving cancer chemotherapy: the expanding spectrum of disease.

Initial reports have suggested that human parvovirus B19 infection in immune-compromised individuals may cause prolonged or chronic bone marrow suppression. We report four children receiving cancer chemotherapy who developed atypical patterns of cutaneous and hematologic disease associated with parvoviral infection. B19 infection was demonstrated by specific serologies. This report suggests that patients undergoing myelosuppressive or immunosuppressive therapy may have unusual manifestations of infection and be at risk for complications associated with this common and widespread pathogen.

Adolescent↗
PubMed1988

Human parvovirus B19-induced vesiculopustular skin eruption.

Erythema infectiosum, fifth disease, is a usually benign macular or maculopapular exanthem of childhood caused by the human parvovirus B19. A 27-year-old woman with a serologically documented human parvovirus infection who presented with a hemorrhagic exanthem and enanthem with areas of pustules and pseudo-pustules is described. The histologic findings were unusual because they combined the histologic features of morbilliform and vesiculopustular viral lesions. This case serves to underscore the occurrence of human parvovirus infection in adults. Further, it demonstrates the need to include parvovirus infection in the differential diagnosis of virally induced vesiculopustular skin eruptions.

Adult↗
PubMed1988

Erythema infectiosum (fifth disease) occurrence in Iowa.

Review of Iowa school nurse surveillance for erythema infectiosum, or fifth disease (FD), since 1973 demonstrated occurrence yearly except 1985 without a clear pattern of disease spread. We conclude that FD is more common than previously recognized. Failure to identify cases representing the background incidence of disease may account for underreporting.

Child↗