Parvovirus B19, a member of the Erythrovirus genus, is the only member of the Parvoviridae family known to be pathogenic in humans. Haematological consequences of B19 infection arise due to a direct cytotoxic effect on erythroid progenitors in bone marrow, resulting in interruption of erythrocyte production. The physiology of host haematopoiesis and competence of the immune response each determines clinical manifestations of B19 infection. A search of the literature revealed that neutropenia and thrombocytopenia due to B19 have been rarely reported in healthy individuals. In Korea, B19 infection has been reported among individuals with underlying disorders such as leukemia or congenital spherocytosis. Among otherwise healthy persons, there have been few reported cases of B19 infection which resulted in anemia, leukopenia, and thrombocytopenia. We herein report, for the first time in Korea, of two children who experienced leukopenia and thrombocytopenia, but not anemia, after B19 infection and recovered uneventfully.
Anemia ; Bone Marrow ; Child ; Erythrocytes ; Erythrovirus ; Hematologic Diseases ; Hematopoiesis ; Humans ; Korea ; Leukemia ; Leukopenia ; Mental Competency ; Neutropenia* ; Parvoviridae ; Parvovirus* ; Physiology ; Thrombocytopenia*

Hydrops fetalis (HF) is a disease characterized by generalized subcutaneous edema and cavity effusion in the fetal stage. We report here on two autopsy cases of HF that were caused by parvovirus B19 (PVB19) infection. The human PVB19 is an erythrovirus that cause diverse clinical manifestations ranging from an asymptomatic or mild presentation to more severe effects such as hydrops fetalis, and this is the only known human pathogenic parvovirus. The gestational ages of the two fetuses were 21 weeks and 23 weeks, respectively. Both fetuses were hydropic and anemic. Hepatic tissues of both fetuses demonstrated erythroblasts with eosinophilic intranuclear inclusions, the so called "lantern cells". PVB19 was confirmed by electron microscopy and immunohistochemical staining. For the diagnosis of this disease, recognition of parvovirus infection as a cause of hydrops fetalis and careful examination of red blood cells with a high-power view are required.
Anemia ; Autopsy* ; Diagnosis ; Edema* ; Eosinophils ; Erythroblasts ; Erythrocytes ; Erythrovirus ; Fetus ; Gestational Age ; Humans ; Hydrops Fetalis* ; Intranuclear Inclusion Bodies ; Microscopy, Electron ; Parvoviridae Infections ; Parvovirus*

Humans ; Parvoviridae Infections ; virology ; Parvovirus B19, Human ; genetics ; metabolism ; physiology

BACKGROUND: The mechanisms responsible for the disturbed hematopoiesis in myelodysplastic syndrome (MDS) include the expansion of abnormal clones, defects in cellular differentiation and the perturbation in the production of hematopoietic regulatory factors. Recently, viral infection such as immunodeficiency virus is known to induce myelodysplasia. And viral infection evokes the production of several cytokines. Therefore, abnormal production of cytokine may be a potential candidate for the pathogenesis of MDS after viral infections such as Epstein-Barr virus (EBV) and human parvovirus B19. METHODS: We investigated bone marrow aspiration slides from 17 patients with MDS referred for the bone marrow study, over a period from January, 1992 to April, 1996. To clarify the contribution of EBV and human parvovirus B19 infections to the pathogenesis of MDS, DNA-PCR for EBV and human parvovirus B19 was used. RESULTS: The EBV and human parvovirus B19-PCR results were all negative in 17 patients with MDS. CONCLUSIONS: EBV and human parvovirus B19 infections may not be associated with the major pathogenesis of MDS.
Bone Marrow ; Clone Cells ; Cytokines ; Hematopoiesis ; Herpesvirus 4, Human* ; Humans* ; Myelodysplastic Syndromes* ; Parvovirus ; Parvovirus B19, Human*

The association between aplastic crisis and human parvovirus (HPV) B19 infection is well described in patients with sickle cell anemia. This association has also been described, although much less frequently, in patients with hereditary spherocytosis (HS). However, most cases of aplastic crises in patients with HS and induced by HPV B19 have been reported in children or adolescents. In this paper, we describe an aplastic crisis induced by HPV B19 in an adult with HS. A 34-year-old female presented with presyncope, febrile sensation, and myalgia. The complete blood counts showed severe anemia. The peripheral blood smear revealed spherocytosis with reticulocytopenia and pancytopenia. The direct Coombs' test was negative; the osmotic fragility test was positive. In the bone marrow aspirates, a few giant pronormoblasts with deep blue cytoplasm, pseudopods, and intracellular inclusion bodies were observed. The patient was given eight units of packed red blood cells. HPV B19 infection was proven by the presence of IgM antibodies to HPV B19 and the detection of viral DNA using the PCR technique. To the best of our knowledge, this is the first report in Korea that describes an adult with aplastic crisis presenting initially with HS.
Adult ; Anemia, Aplastic/*etiology ; Female ; Humans ; Parvoviridae Infections/*complications/diagnosis ; Parvovirus B19, Human ; Spherocytosis, Hereditary/*diagnosis

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.
DNA, Viral/*analysis ; Parvoviridae Infections/*virology ; Parvovirus B19, Human/genetics ; Parvovirus B19, Human/*isolation & purification ; Placenta/virology ; Pregnancy Complications, Infectious/diagnosis ; Pregnancy Complications, Infectious/*virology ; Viral Nonstructural Proteins/*analysis

BACKGROUND: Human parvovirus B19 (B19V) is one of the smallest DNA viruses and shows great resistance to most disinfectants. Therefore, it is one of the common contaminant pathogens present in blood and plasma products. Parvovirus 4 (PARV4) is a newly identified parvovirus, which is also prevalent in parenteral transmission. In this study, we aimed to evaluate the prevalence of B19V and PARV4 DNA among patients with hemophilia in Birjand County in eastern Iran. METHODS: This was a cross-sectional epidemiological study comprising nearly all people with hemophilia in this region. Whole blood samples were taken after patient registration and sent for plasma isolation. After nucleic acid extraction, B19V was detected with real-time polymerase chain reaction, PARV4 DNA was then detected using sensitive semi-nested PCR. RESULTS: In total, there were 86 patients with hemophilia, with mean age 28.5±1.5 years. Of these, 90.7% were men and 9.3% women; 84.9% had hemophilia A and 7.0% had hemophilia B. We found 11 patients (12.8%) were positive for B19V DNA and 8 were positive (9.3%) for PARV4 DNA. The prevalence of B19V was higher in middle-aged groups rather than younger people, whereas PARV4 infection was more common in younger patients (P < 0.05). CONCLUSION: There was a high prevalence of B19V and PARV4 infection in this high-risk group of patients with hemophilia. Due to the clinical significance of the B19 virus, imposing more precautionary measures for serum and blood products is recommended.
Disinfectants ; DNA ; DNA Viruses ; Epidemiologic Studies ; Female ; Hemophilia A* ; Hemophilia B ; Humans* ; Iran ; Male ; Parvovirus B19, Human* ; Parvovirus* ; Plasma ; Polymerase Chain Reaction ; Prevalence ; Real-Time Polymerase Chain Reaction

BACKGROUND: Human parvovirus B19 infection has been known to cause chronic anemia, pure red cell aplasia, glomerulopathy and allograft dysfunction in kidney transplant (KT) recipients. The aim of this study was to evaluate the prevalence and clinical significance of B19 infection in KT recipients. METHODS: Five hundred and thirty seven serum samples from 167 KT recipients were included in the present study. The prevalence of B19 infection was based on either qualitative or quantatitive polymerase chain reaciton (PCR) with LightCycler Parvovirus B19 Quantification kit (Roche Diganostics, Mannheim, Germany). Clinical significance of B19 infection was investigated by retrospective review of hemoglobin levels and the results of kidney and bone marrow biopsies. RESULTS: Overall PCR positive rate was 18.3% (98/537) and 52 out of 167 (31.1%) KT recipients showed at least one positive PCR result. In addition, 20 out of 167 subjects (12.0%) showed PCRpositivity more than two consecutive times and they had significantly lower hemoglobin level than those with negative PCR result or only one-positive result (P < 0.0001 by ANOVA and multiple comparison). In addition, two patients (1.2%) suffered from pure red cell aplasia which was confirmed by bone marrow biopsy. Nevertheless, B19 infection did not seem to affect the graft outcome. CONCLUSIONS: The parvovirus B19 infection in KT recipeints was not uncommon and was associated with low hemoglobin level and pure red cell aplasia after KT. Therefore, routine examination for the B19 infection should be provided for the KT recipients. To the best of our knowledge, this is the first report of the incidence and clinical significance of B19 infection in Korean KT recipients.
Allografts ; Anemia ; Biopsy ; Bone Marrow ; Humans* ; Incidence ; Kidney Transplantation ; Kidney* ; Parvovirus ; Parvovirus B19, Human* ; Polymerase Chain Reaction ; Prevalence ; Red-Cell Aplasia, Pure ; Retrospective Studies ; Transplantation* ; Transplants

BACKGROUND: The pathogenic human parvovirus B19 is the etiologic agent of erythema infectiosum and causes other events including aplastic crisis,hydrops fetalis and fetal loss.Recently,it has been reported in many articles that human parvovirus B19 infection is associated with rheumatoid arthritis (RA).In contrast to these reports from the United Kingdom,Germany,Japan and China,different results were reported that there is no association between human parvovirus B19 and the pathogenesis of RA in Northern Ireland,Finland and France.This study aimed to investigate the association between human parvovirus B19 and RA in Korea. METHODS: Sera from 104 patients with RA,40 with osteoarthritis (OA)and 32 with systemic lupus erythematosus (SLE)were tested for IgG and IgM of human parvovirus B19 by ELISA (Biotrin),respectively. RESULTS: There were no statistical differences among RA,OA and SLE patients in both anti-human parvovirus B19 IgG and IgM (p>0.05).Human parvovirus B19 IgM was positive in only four RA patients and negative in all SLE and OA patients. CONCLUSION: Human parvovirus B19 infection showed no association with RA in Korea,which is different from reports from other countries,especially Japan and China which are our neighbors.We thought that this result was due to the ethnic or national differences of baseline titer of anti-human parvovirus B19.Therefore anti-human parvovirus B19 test for RA patients is not necessary in Korea.In conclusion,we suggest that the indication and interpretation of anti-human parvovirus B19 testing in RA patients should be applied differently for each nation.
Arthritis, Rheumatoid* ; China ; Enzyme-Linked Immunosorbent Assay ; Erythema Infectiosum ; Humans* ; Immunoglobulin G ; Immunoglobulin M ; Japan ; Korea* ; Lupus Erythematosus, Systemic ; Osteoarthritis ; Parvovirus ; Parvovirus B19, Human*

OBJECTIVE: The association of parvovirus B19 infection with many rheumatologic disease, including systemic lupus erythematosus, rheumatoid arthritis, Sjogren's syndrome, polymyositis has been suggested, although the exact relationship between the infection and these disorders is not understood. Several cases of fibromyalgia have been reported after parvovirus B19 infection, but systemic investigation of parvovirus B19 infection in Korean patients with fibromyalgia has not been performed. This study was designed to investigate the clinical significance of human parvovirus B19 infection in Korean patients with fibromyalgia. METHODS: Serum from 54 patients with fibromyalgia and 61 age and sex matched healthy controls were tested for IgM and IgG anti-parvovirus B19 antibodies by two different commercially available ELISA kits and presence of parovovirus B19 DNA was measured by PCR. RESUTLS: IgM antibodies to parvovirus B19 were detected 1 fibromyalgia patient in one assay and 1 patient in the other assay. No controls had positive IgM antibodies. No difference was seen between fibromyalgia patients and controls with the IgG andtibodies to parvovirus B19 in two different assays. Parvovirus B19 DNA was detected in 3 fibromyalgia patients, but not in controls. CONCLUSION: Our data showed that fibromyalgia could be triggerd by parvovirus B19 infection, but parvovirus B19 is unlikely to play a significant role in the pathogenesis of Korean patients with fibromyalgia.
Antibodies ; Arthritis, Rheumatoid ; DNA ; Enzyme-Linked Immunosorbent Assay ; Fibromyalgia* ; Humans* ; Immunoglobulin G ; Immunoglobulin M ; Lupus Erythematosus, Systemic ; Parvovirus ; Parvovirus B19, Human* ; Polymerase Chain Reaction ; Polymyositis ; Sjogren's Syndrome