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PubMedDate not supplied

Parvovirus B19 in pregnancy.

Parvovirus B19 is a common, self-limiting, usually benign childhood virus that causes erythema infectiosum, also known as fifth disease. Acute infection in pregnancy can cause B19 infection in the fetus, leading to nonimmune fetal hydrops or fetal loss, depending on gestational age at the time of infection. Susceptibility to parvovirus B19 infection should be determined in selected pregnant women at high risk for exposure, and counseling should be provided regarding prevention, testing, and treatment options if exposed.

Erythema Infectiosum↗

PubMedDate not supplied

[Human parvovirus B19 (HPV-B19), a clinical overview with emphasis of rheumatologic manifestations].

The human parvovirus B19 (HPV-B19) causes a spectrum of diseases: Erythema infectiosum (fifth disease), aplastic crises in patients with chronic hemolytic anemias, chronic bone marrow failure in patients with congenital or acquired immune deficiency, vascular purpura, hydrops fetalis, abortion, intrauterine fetal death and HPV-19-arthropathy. In this review we will discuss the clinical pattern, the diagnostic questions and therapeutic possibilities particularly relating to rheumatic manifestations.

Adult↗

PubMed1996

[Cutaneous manifestations of parvovirus B19 infection].

Parvovirus B19 can cause a wide range of cutaneous or extracutaneous diseases. There are three types of exanthemas, erythematous maculopapulous or vesicopapulous exanthema including erythema infectiosum, the less common maculoerythematous exanthemas and purpural exanthemas including vascular, thrombocytopenic or non-vascular or non-thrombopenic forms such as le socks and gloves syndrome. Reports of other manifestations have been more sporadic: generalized livedo, polymorphous rash, lupus-like rash and Kawasaki syndromes. The presence of unusual presentations and the risk of fetomaternal transmission are two reasons for better understanding this virus.

Erythema Infectiosum↗

PubMed1995

[[Human parvovirus B19 and its clinical significance].

Human parvovirus B19 causes erythema infectiosum (fifth disease) and aplastic crisis. In pregnancy, B19 may be transmitted on to the fetus resulting in hydrops fetalis. B19 is sometimes associated with thrombocytopenia and vasculitis. In immunocompromised patients, B19 may persist causing chronic infection. Several methods for detecting B19 virus or specific antibodies are now available. B19 infection does not usually require therapy. Efficacy of immunoglobulins in chronic B19 infection has been demonstrated.

Antibodies, Viral↗

PubMedDate not supplied

Severe pneumonia after heart transplantation as a result of human parvovirus B19.

The diverse manifestations of human parvovirus B19 infection have been well established. Erythema infectiosum, fetal hydrops, adult arthropathy, and aplastic anemia in patients with hemoglobinopathies or underlying immunocompromise have been described. Recently we successfully treated a patient who, after heart transplantation, had fever, rash, and pneumonia with respiratory failure caused by human parovirus B19. Human parovirus B19 has not been reported previously as a pathogen causing pulmonary disease after pediatric heart transplantation, and we wish to report it at this time.

Antibodies, Viral↗

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↗

PubMed1997

Parvovirus B19 in human disease.

Parvovirus B19, the only known human pathogenic parvovirus, is associated with a wide range of disease manifestations. In healthy individuals, the major presentation of B19 infection is erythema infectiosum. In patients with underlying hemolytic disorders, infection is the primary cause of transient aplastic crisis. In immunosuppressed patients, persistent infection may develop that presents as pure red cell aplasia and chronic anemia. In utero infection may result in hydrops fetalis or congenital anemia. Diagnosis is based on examination of bone marrow and virologic studies. Much is known of the pathophysiology of the virus, and studies are in progress to develop a vaccine to prevent this widespread infection.

Adult↗

PubMed1994

Acute polyarthritis. Fifth disease passed from child to adult.

Physicians are familiar with the "slapped cheek" rash seen in childhood cases of erythema infectiosum. Less well known is that infection with its pathogen, parvovirus B19, often becomes manifest in adults as acute viral arthropathy. In evaluation of suspected cases, a complete blood cell count and blood chemistry profile are useful additions to thorough history taking and physical examination. Differential diagnosis includes Lyme disease, other viral infections, acute rheumatoid arthritis, systemic lupus erythematosus, and psoriatic arthritis. Treatment is symptomatic with nonsteroidal anti-inflammatory drugs.

Acute Disease↗

PubMed1996

Conjunctivitis associated with fifth disease in a child: a case report.

BACKGROUND: Erythema infectiosum, fifth disease, is a mildly contagious childhood illness that may present with viral conjunctivitis. It is characterized by a facial rash with a "slapped-cheek" appearance and "lacy-like" rash on the trunk and extremities. Fifth disease is believed to be caused by parvovirus B19. METHODS/RESULTS: A case of 10-year-old child with fifth disease and conjunctivitis is presented. CONCLUSIONS: The progression, differential diagnosis, and management of fifth disease are reviewed.

Anterior Chamber↗

PubMed2006

Clinical aspects of parvovirus B19 infection.

Parvovirus B19 is a significant human pathogen that causes a wide spectrum of clinical complications ranging from mild, self-limiting erythema infectiosum in immunocompetent children to lethal cytopenias in immunocompromised patients and intrauterine foetal death in primary infected pregnant women. The infection may also be persistent and can mimic or trigger autoimmune inflammatory disorders. Another important clinical aspect to consider is the risk of infection through B19-contaminated blood products. Recent advances in diagnosis and pathogenesis, new insights in the cellular immune response and newly discovered genotypes of human parvoviruses form a platform for the development of modern therapeutic and prophylactic alternatives.

Autoimmune Diseases↗

PubMed1995

Parvovirus: the expanding spectrum of disease.

Treatment of parvovirus infections among immunocompromised hosts using immunoglobulin has provided the clinician with a useful therapeutic tool but has also highlighted the problems concerning chronic disease states. The discovery of the human parvovirus B19 in 1975 and subsequent studies of its effects in humans have identified this virus as the causative agent of a broad spectrum of diseases. Recent improvements regarding the development of sensitive PCR techniques and methods for cultivation have provided new insight into its pathogenic role, its virology and immunology, and the varied clinical manifestations. The current state of knowledge concerning parvovirus enabled us to divide the long list of diseases caused by this virus into three main categories: (1) disease found among normal hosts (asymptomatic disease, erythema infectiosum, arthropathy, hydrops fetalis), (2) hematologic diseases (aplastic crisis, chronic anemia, idiopathic thrombocytopenic purpura, transient erythroblastopenia of childhood, Diamond-Blackfan anemia) and, finally, (3) a heterogeneous group of diseases, in which the etiologic role of parvovirus is less clear and sometimes putative (neurologic disease, rheumatologic disease, vasculitic and myocarditic syndromes). In particular, arthropathy, hydrops fetalis and the hematologic disorders may be of pediatric concern. Consequently, it is of paramount importance that in all of these cases the clinician includes parvovirus as a differential diagnosis.

Erythema Infectiosum↗

PubMed1995

[Parvovirus B19 infection as the cause of hepatitis and neutrophil granulocytosis in a 20-year old woman].

A case of Parvovirus B19 infection (erythema infectiosum) in a 20 year old woman is presented. The patient presented with fever, arthritis in one knee, neutrophil granulocytosis and biochemical evidence of hepatitis. Serological evidence of Parvovirus B19 infection was found as the only explanation of the clinical picture. Hepatitis was due to Parvovirus B19 infection as there was no serological evidence of EBV or CMV reactivation. Neutrophil granulocytosis and thrombocytosis were found and were probably due to an active bone marrow in the recovery phase of bone marrow aplasia.

Adult↗

PubMed1994

The frequency of human parvovirus B19 infection in nonimmune hydrops fetalis.

Intrauterine infection of human parvovirus B19 has recently been identified as an etiology for nonimmune hydrops fetalis (NIHF) and fetal death. To examine the frequency of B19 infection in cases of NIHF, forty two cases of NIHF of unknown cause were tested for the presence of B19 antibodies by enzyme-linked immunosorbent assay (ELISA) and B19 DNA by polymerase chain reaction (PCR). Three maternal sera were positive for B19 IgM antibody and one fetal serum was positive for B19 DNA. Overall, four (10%) of the 42 cases were positive for B19 infection. All of the four cases positive for B19 infection were found during or just before an outbreak of erythema infectiosum and the incidence was calculated at 36% if only cases found during the outbreak were collected. In all four cases of B19 infection, NIHF was diagnosed at 20 to 23 weeks of gestation, which suggested that B19 infection might be a particular threat to the fetus during this stage of gestation. In conclusion, B19 infection may contribute to 10% of cause unknown NIHF and the incidence may be higher if cases during outbreaks are exclusively collected.

Antibodies, Viral↗

PubMed1996

Bilateral brachial plexus neuritis following parvovirus B19 and cytomegalovirus infection.

A man, 23 years of age, had a typical erythema infectiosum, complicated by a severe bilateral brachial plexus neuritis. Motor function recovered slowly and only partially after 6 months. An infection by human parvovirus B19 was demonstrated, with strongly positive and gradually declining IgM antibodies and viral DNA detectable in serum for more than 3 months. There was also clear evidence of a recent infection by cytomegalovirus. The interaction between these two viruses could be responsible for this rare and severe complication of common infections in this patient.

Adult↗

PubMedDate not supplied

Human parvovirus B19 infection: clinical and epidemiological study of 24 cases.

From March 1994 to November 1995 24 cases of human parvovirus B19 infection were seen at the Infectious Diseases Department of the Hospital Universitário Antônio Pedro, Niterói-RJ. Serum samples for IgM detection (capture enzyme immunoassay) were positive from the 1st to the 27th day after the onset of the exathema. The classical features of erythema infectiosum (slapped cheecked syndrome) were observed in 8 (33.3%) cases all of them children. Eight patients (6 adults and 2 children) presented a symmetrical polyartropathy, seen more frequently in women. These results show that B19 infection diagnosis is difficult when the disease does not present the classical features and because of the frequent involvement of the joints this infection should be considered in the differential diagnosis of early rheumatoid arthritis.

Adolescent↗

PubMed1995

[Human parvovirus B19 infection. Update].

Pathogenicity of parvovirus B19 has been demonstrated. The spectrum of clinical manifestations varies according to the age and immune status of affected patients. Parvovirus B19 is the aetiologic agent of erythema infectiosum in children. In normal adults, it is responsible for acute, bilateral and symmetrical arthritis, although chronic arthritis can develop. Parvovirus B19 has a particular tropism for erythroid precursors: in patients with underlying hemolysis, it induces transient aplastic crisis; in immunosuppressed patients the virus can lead to chronic pure red cell aplasia. Hydrops fetalis is one of the most severe manifestation of the infection. Diagnosis of recent parvovirus B19 infection is based upon serology and PCR, especially in immunosuppressed patients in whom polyvalent intravenous immunoglobulins must be started. The link between parvovirus B19 and systemic vasculitis is questioned.

Acute Disease↗

PubMed2000

Parvovirus B19 transmitted by bone marrow.

We describe a case of symptomatic parvovirus B19 infection transmitted by bone marrow (BM). The infection caused prolonged anaemia, thrombocytopenia, arthralgia and erythema infectiosum in a 16-year-old girl with acute myeloid leukaemia receiving a BM transplant (BMT). The BM donor was a 19-year-old asymptomatic brother who had parvovirus B19 viraemia at the time of BM harvest. Sequencing of the VP2 gene from the patient and the donor showed a perfect match of DNA sequences, confirming the mode of transmission. Parvovirus B19 represents a potential complicating factor in patients undergoing BMT, but screening by polymerase chain reaction (PCR) of donor BM may reduce the risk of infection.

Adolescent↗

PubMed1999

[Parvovirus B19 infection--an insidious chameleon].

Parvovirus B19 is a common source of infection with a seroprevalence of 60-70 per cent in the adult population. The most common manifestation is erythema infectiosum ('fifth disease'), with exanthem, fever and upper airway symptoms in children. The infection can give rise to a multifacetted clinical picture and is probably underdiagnosed, particularly in risk groups (individuals with haemolytic anaemia or immunosuppression, and fetuses). Serological diagnosis can now be complemented with the demonstration of viral DNA using the PCR (polymerase chain reaction) test in various body fluids, or tissue biopsy. Recent years have witnessed manifest increase in clinical knowledge of parvovirus B19-associated complications, and their diagnosis and treatment.

Adolescent↗