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PubMed1996

Evaluation of four commercial enzyme immunoassays for detection of immunoglobulin M antibodies to human parvovirus B19.

Four commercial enzyme immunoassays (EIAs) for the detection of parvovirus B19-specific immunoglobulin M (IgM) antibodies [Biotrin Parvovirus B19 IgM (Biotrin International, Ireland); Parvoscan B19 IgM (Euro-Diagnostica, Sweden); Parvovirus IgM (Immunobiological Laboratories [IBL], Germany); and human parvovirus B19 IgM (Hillcrest Biologicals, USA)] were compared to indirect immunofluorescence assay (IFA) and polymerase chain reaction (PCR). Using IFA as the reference test, high sensitivities (> or = 97%) were observed with all four EIAs, though the specificities of the Biotrin and IBL EIAs (99% and 96% respectively) were significantly higher than those of the Hillcrest and Euro-Diagnostica EIAs (81% and 79% respectively).

Antibodies, Anti-Idiotypic↗

PubMed1992

Different syndromes associated with B19 parvovirus viraemia in paediatric patients: report of four cases.

The broad spectrum of clinical manifestations associated with B19 parvovirus often allows the infection to go unrecognized. We tested for the presence of B19 parvovirus and the specific serological response in serum from hospitalized patients submitted for viral investigations without any specific indications for B19 parvovirus. We diagnosed human parvovirus B19 infection in four paediatric patients showing different clinical manifestations. The patients, aged between 5 and 8 years, were admitted to hospital for: (1) petechial rash; (2) mononucleosis-like syndrome; (3) neurological syndrome; and (4) respiratory disease (in an immunodeficient patient).

Child↗

PubMedDate not supplied

Acute parvovirus B19 infection in pregnant women--an analysis of serial samples by serological and semi-quantitative PCR techniques.

The serological and virological course of parvovirus B19 infection was followed in 14 women who suffered symptomatic or subclinical acute infection during pregnancy. Serial serum samples from the patients were tested for IgG and IgM antibodies and the levels of parvovirus B19 DNA were monitored using a semi-quantitative PCR assay. In addition, the outcome of the pregnancies was documented by clinical information and by testing cord blood for parvovirus B19 specific antibodies as well as for parvovirus B19 DNA by PCR. Levels of IgG antibodies rose steadily within 2 months of infection and in some cases began to decline at the end of pregnancy. IgM antibodies were usually detected for at least 2 months and persisted for as long as 9 months in one case. Viral DNA was detectable for at least 8 weeks following infection and semi-quantitative analysis revealed a gradual reduction in virus load during the viraemic phase of infection. There were no apparent differences in the course of antibody development and duration of viraemia in symptomatic versus subclinical infections.

Antibodies, Viral↗

PubMed2006

Detection of human parvovirus B19 nonstrutural protein DNA by nested-polymerase chain reaction in gravida serum and pregnant tissues.

A new nested-polymerase chain reaction (nested-PCR) assay was developed to detect human parvovirus B19 DNA corresponding to the nonstructural protein in clinical specimens in a routine diagnostic laboratory. The sensitivity of this highly specific assay was up to 0.005 fg of B19 DNA. Parvovirus B19 was identified in sera of 20 pregnant women with abnormal pregnant outcome. Among these 20 cases, intrauterine parvovirus infection did exist in 7 pregnant women because parvovirus B19 DNA was detected in the pregnant tissues of them such as placenta tissues, chorionic villi, amniotic fluid, fetal spleen, liver and abdominal fluids.

Adult↗

PubMed2004

Frequency and quantity of the parvovirus B19 genome in endomyocardial biopsies from patients with suspected myocarditis or idiopathic left ventricular dysfunction.

Parvovirus B19 (PB19) has been identified as a possible cause of myocarditis and heart failure in both children and adult patients. This study used real time PCR analysis, to determine the frequency and to quantify PB19 viral genomes in endomyocardial tissue samples from 80 adult patients with clinically suspected myocarditis or idiopathic left ventricular dysfunction and from 36 controls. Histological (Dallas classification) and immunohistological analyses were performed to detect myocardial inflammation in the endomyocardial biopsies.PB19 genomic DNA was found in nine of 80 patients (11.2%), 4 out of 31 (12.9%) patients with inflammatory infiltrates detected via immunohistological methods and 5 out of 49 (10.2%) patients with left ventricular dysfunction without myocardial inflammation. The copy numbers for PB19 DNA ranged between 30 and 3900 per microg of cellular DNA. Four patients with clinically suspected myocarditis had copy numbers for PB19 DNA of 70, 740, 3400 and 3900, respectively, per microg of cellular DNA in the endomyocardial biopsy. Five patients with idiopathic left ventricular dysfunction had copy numbers for PB19 DNA of 30, 38, 52, 58 and 90, respectively, per microg of cellular DNA in the endomyocardial biopsy. The amplicon of one of the nine positive PCR fragment was sequenced and was found to be fully identical in the highly conserved sequence of published Parvovirus B19 VP1/VP2 genes (NCBI gene bank). In all patients, acute myocarditis was excluded according to the Dallas classification. All biopsies of 36 controls with no history of myocarditis or recent viral infection were negative for myocardial inflammation and parvovirus B19 genomes. In summary, Parvovirus B19 DNA is present within the myocardium of patients with suspected myocarditis and idiopathic left ventricular dysfunction and can be detected and quantified in endomyocardial specimens via real time PCR.

Adult↗

PubMed2007

Serous retinal detachment in a patient with aplastic anemia associated with parvovirus B19 infection.

BACKGROUND: We report a case of unilateral serous retinal detachment (RD) associated with parvovirus B19 infection. CASE REPORT: A 28-year-old woman had a clinical history of autoimmune hemolytic anemia and pure red cell aplasia associated with parvovirus B19 infection. She demonstrated focal serous RD without retinal exudates. A focal cataract and anterior vitreous cells were also observed. Fluorescein angiography (FA) revealed accumulation of subretinal fluid, but no vascular leakage. After vitrectomy, the retina was re-attached and visual acuity returned to 20/20. IgM antibody to parvovirus and viral DNA were detected by polymerase chain reaction in the vitreous fluid obtained at surgery. CONCLUSION: To our knowledge, this is the first reported case of the presence of anti-viral IgM and viral DNA in vitreous sample. Furthermore, the ocular findings in our patient are definitively different from previously reported cases of parvovirus-associated ocular disorders.

Adult↗

PubMedDate not supplied

Parvovirus infects cardiac myocytes in hydrops fetalis.

Parvovirus infection during pregnancy is an important cause of hydrops fetalis. It is attributed to anemia caused by viral-induced destruction of red blood cells. Infection of other organs has been reported including the heart, liver, and lungs. Few of these reports, however, convincingly demonstrate virions within the functional parenchyma of the tissue. This is of particular concern regarding myocardium in the context of hydrops fetalis which is, in part, due to cardiac failure. The problem in routine pathology practice is that most fetuses with the infection are macerated. This, in part, probably explains the paucity of published information on cardiac involvement. This study examined five cases of fatal hydrops fetalis with variable maceration with serologically proven parvovirus B19 infection. Transmission electron microscopy of cardiac tissue demonstrated intranuclear virions in both erythroid precursor cells and in cardiac myocytes in three of these cases. In each of these, immuno-gold electron microscopy provided confirmatory evidence of parvovirus infection. Virions were not identifiable where maceration had caused disintegration of nuclei in the myocytes. In addition, virions were absent in the three negative control cases where retroplacental hemorrhage was confirmed as the cause of death. This study suggests that parvovirus infection of cardiac myocytes may play a more important role in causing hydrops fetalis than previously realized. It also demonstrates that maceration should not discourage the use of electron microscopy.

Adolescent↗

PubMed2002

Unusual localisation of chronic arthropathy in lumbar facet joints after parvovirus B19 infection.

Human parvovirus B19 infection may be responsible for acute and chronic arthropathy. We present the case of a woman, who developed a severe chronic parvovirus B19 infection with persistence of DNA parvovirus B19, which was detected in the serum by polymerase chain reaction (PCR). After intravenous immunoglobulin administration she noted a disappearance of the general symptoms and the virus became undetectable by PCR in the serum. However, 1 month later back pain appeared. Magnetic resonance imaging showed bilateral effusions of the apophyseal joints of the lumbar spine (L4-L5). Spine involvement is rarely described during acute or chronic parvovirus B19 infection. In this case it was not possible to determine whether the facet joint arthropathy was reactive or due to persistent articular infection, or induced by immunoglobulin therapy.

Adult↗

PubMed2000

Hepatic dysfunction due to parvovirus B19 infection.

Parvovirus B19 has been associated with different diseases. However, hepatic involvement has rarely been reported in adult patients with parvovirus B19 infection. Herein, we report two adult patients with hepatic dysfunction associated with acute parvovirus B19 infection. We believe that hepatic involvement in the setting of parvovirus B19 infection is more common than suspected, and that antibodies against this agent should be routinely measured in patients with hepatic dysfunction of unclear etiology.

Adult↗

PubMed2004

Sequence analysis of an Asian isolate of minute virus of canines (canine parvovirus type 1).

Minute virus of canines (MVC), also known as canine parvovirus (CPV) type 1, is an autonomous parvovirus that infects domestic dogs worldwide and responsible for clinical problems of neonates and pregnant bitches. It was preliminary described that MVC is antigenically as well as genetically different from CPV type 2 that emerged later. However, much of MVC is still obscure since only a limited number of MVC isolates have been available for the study. MVC infections of Japanese and Korean dogs were epidemiologically studied in the previous study, and several MVC isolates could be cultivated in vitro. In the present study an almost full-length nucleotide sequence of a Korean MVC strain HM-6 genome was obtained and comparatively analyzed with those of the American MVC strain GA3 characterized recently. Genome structure of the HM-6 strain was similar to the GA3 strain showing 96.4% identity at the nucleotide sequence. Each of the deduced amino acid sequences of NS1, NP-1, and VP1/2 showed homology of 96.5%, 92.5%, and 97.5% between the HM-6 and GA3 strains. When compared with other parvovirus species, the HM-6 strain was most closely related to bovine parvovirus (BPV) as described for the GA3 strain. These results suggest that MVC together with BPV can possibly be classified into a new clade in the Parvovirinae subfamily.

Animals↗

PubMed2003

Influenza B pneumonia with Staphylococcus aureus superinfection associated with parvovirus B19 and concomitant agranulocytosis.

An 11-year-old patient with anamnestic fever for 3 days and signs of upper respiratory tract infection underwent fulminant Staphylococcus aureus pneumonia with concomitant agranulocytosis. From autopsia influenza B virus and parvovirus B19 were detected by nucleic acid amplification technique (NAT). Specific IgG but no IgM points to preexisting parvovirus B19 infection. Whether in this case agranulocytosis can be interpreted as early manifestation of reactivated parvovirus B19 infection is under discussion. Therefore, parvovirus B19 could have provoked a foudroyant course of influenza B pneumonia which was superinfected with S. aureus.

Agranulocytosis↗

PubMed2006

Serologic and molecular detection of human Parvovirus B19 infection.

Following its identification by Yvonne Cossart in 1975, human Parvovirus B19 has been recognized as the causative agent of a wide range of diseases. In childhood, the most common disease is a typical exanthema called "fifth disease". In adults, viral infection may be responsible for fetal loss and for aplastic anaemia in immuno-compromised patients. Because persistent viral infection may induce an autoimmune response, Parvovirus B19 is emerging as an environmental factor linked to the pathogenesis of autoimmunity. As a result of its expanding disease spectrum, Parvovirus B19 is the subject of intense efforts to clarify the pathogenesis of virus-related disorders as well as improve diagnostic laboratory testing including standardization of serological and nucleic acid-based detection assays. Enzymatic immunoassays based on conformational antigens have proven to be the most important tools for accurate diagnosis in the majority of cases. In other selected clinical cases, the detection of Parvovirus B19 infection can be complemented by PCR and, more recently, by the real-time PCR.

Humans↗

PubMed2005

Critical function of the CD40 pathway in parvovirus B19 infection revealed by a hypomorphic CD40 ligand mutation.

Parvovirus B19-induced chronic anemia has been associated with failure to mount an effective neutralizing antibody response. We describe an adolescent male with a 13-year history of parvovirus B19-induced anemia as the primary manifestation of X-linked hyper IgM immunodeficiency (XHIM). This patient, whose serum IgG concentration was at the low end of the normal range and who mounted IgG antibody responses to T cell-dependent antigens, suffered from a nonsense mutation (R11 --> X) in the CD40 ligand (CD40L) gene. This resulted in low-level expression of a mutant CD40L predicted to lack the cytoplasmic domain. Intravenous immunoglobulin therapy alone or in combination with interferon gamma, given in the context of impaired Th1 cytokine production, suppressed but did not eradicate the infection. These results highlight the critical function of the CD40/CD40L pathway in parvovirus B19 infection and suggest that subtle defects in this pathway may underlie cases of chronic parvovirus B19 infection atypical of XHIM.

Adolescent↗

PubMed2006

Increased seroprevalence of parvovirus B 19 IgG in complex regional pain syndrome is not associated with antiendothelial autoimmunity.

The etiology of complex regional pain syndrome (CRPS) is unclear yet. Recently autoantibodies and antecedent viral infections have been discussed to be involved in the pathogenesis of CRPS. We investigated sera from 39 CRPS patients and healthy controls for parvovirus B19 IgG and the occurrence of antiendothelial autoantibodies (AECA). CRPS patients showed a higher seroprevalence of parvovirus B19 IgG than controls (p < 0.01). All CRPS 2 patients were positive. 10.2% of the CRPS patients and 10.0% of the controls had AECA (n.s.) and AECA were not associated with parvovirus B19 seropositivity. Our findings suggest the involvement of parvovirus B19, but not autoantibody-mediated endothelial cell damage, in the pathogenesis of CRPS.

Adult↗

PubMed2005

IgE, CD8(+)CD60+ T cells and IFN-alpha in human immunity to parvovirus B19 in selective IgA deficiency.

Although IgE is implicated in viral immunity, its role in parvovirus B19 immunity and its relationship to other immunological states has not been studied. Total serum immunoglobulin levels, IgG and IgE anti-parvovirus B19, blood lymphocyte numbers, and epsilon and cytokine specific mRNA were determined in pediatric patients with normal serum IgA levels (IgA+) and selective IgA deficiency (IgA-) on days 0 (initial diagnosis) and 14, and 3 years after recovery (nephelometry, Western blot test, flow cytometry, reverse transcriptase-polymerase chain reaction). We found that both patients had serum IgM, IgG, IgE, and IgA levels within normal ranges on day 0 to 3 years, excluding IgG(1) and IgA in the IgA- patient, which were elevated and negative, respectively, and IgE in the IgA+ patient, which was elevated (>100 IU/ml). The serum IgA+ and IgA- patients made IgE (and IgG) anti-parvovirus B19 at all time points. Excluding CD8(+)CD60+ T cells, determinations of T, B, and NK lymphocyte subsets always were within normal ranges. In both patients, CD8(+)CD60+ T-cell numbers were within normal ranges on day 0, but dramatically increased on day 14 (more than fivefold). At 3 years, they had returned to normal in the IgA+ patient, but remained high in the IgA- patient. On day 0 to 3 years, peripheral blood mononuclear cells of both patients expressed epsilon- and interferon (IFN)-alpha-specific mRNA. On day 0, the IgA+ patient expressed interleukin (IL)-4 and IL-10, but not IL-2, IFN-gamma, or IL-6 mRNA; the IgA- patient expressed IL-6 and IL-10 mRNA, but not IL-4, IL-2, or IFN-gamma mRNA. At 3 years, the IgA+ patient expressed mRNA for all cytokines, but the IgA- patient did not express mRNA for any of these cytokines. Our results suggest that IgE is important in parvovirus B19 immunity, and that IFN-alpha and CD8(+)CD60+ T cells may regulate IgE memory responses and isotype switching.

Antibodies, Viral↗

PubMed2006

Cardiac troponin I release in non-ischemic reversible myocardial injury from parvovirus B19 myocarditis.

Cardiac troponin I is released from myocytes in both reversible and irreversible myocardial injury. The changes in myocyte membrane permeability resulting from the injury could be enough for the release of cardiac troponins from the free cytosolic pool of myocytes without structural damage. We report a case of parvovirus B19 myocarditis in a 26-year-old male who developed regional wall motion abnormalities and severe left ventricular systolic dysfunction with elevated serum levels of cardiac troponin I (peak=11.7 ng/ml). Diagnosis of parvovirus myocarditis was confirmed by presence of high titers of parvovirus B19 IgG and identification of parvovirus B19 DNA by polymerase chain reaction. Within a few days of supportive treatment, the regional wall motion abnormalities resolved, the cardiac function recovered, and the elevation in serum cardiac troponin I subsided. This case further denotes the possibility of release of cardiac troponin I in non-ischemic, reversible myocardial injury.

Adult↗

PubMed2006

Risk of perinatal transmission of rubella and parvovirus B19 in Jordanian pregnant women.

The seroprevalence and the risk of perinatal transmission of rubella virus (RV) and human parvovirus B19 were assessed in 439 Jordanian pregnant women. Seroprevalence data indicate that 43.7%, 48.7% and 19% of women are susceptible to RV, parvovirus B19 infections and both, respectively. A total of 12.2% and 20.2% of RV susceptible women are at the first and second trimester of gestation, respectively. They are at risk of bearing infants with congenital rubella syndrome (CRS). However, 15% and 23% of parvovirus B19 susceptible women are at the first and second trimester of gestation, respectively. They are at risk of fetal loss or hydrops fetalis. Prenatal screening for these viruses, postpartum MMR vaccination and parvovirus B19 passive immunization are recommended.

Adolescent↗

PubMed2004

Construction and sequencing of an infectious clone of the human parvovirus B19.

Human parvovirus B19 has a nonenveloped, icosahedral capsid packaging a linear single-stranded DNA genome of 5.6 kb with long inverted terminal repeats (ITR) at both the 5' and 3' end. Previous attempts to construct a full-length B19 clone were unsuccessful due to deletions in the ITR sequences. We cloned the complete parvovirus B19 genome with intact ITRs from an aplastic crisis patient. Sequence analysis of the complete viral genome indicated that both 5' and 3' ITRs have two sequence configurations and several base changes within the ITRs compared to previous published sequences. After transfection of the plasmid into permissive cells, spliced and non-spliced viral transcripts and viral capsid proteins could be detected. Southern blot analysis of the DNA purified from the plasmid-transfected cells confirmed parvovirus B19 DNA replication. Production of infectious virus by the B19 plasmid was shown by inoculation of cell lysate derived from transfected cells into fresh cells. Together, these results indicate the first successful production of an infectious clone for parvovirus B19 virus.

3' Untranslated Regions↗