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

Genotype ; Hepatitis B, Chronic ; complications ; Hepatitis C, Chronic ; complications ; Humans ; Parvoviridae Infections ; complications ; virology ; Parvovirus ; classification ; genetics ; isolation & purification ; Parvovirus B19, Human ; isolation & purification

Clinical characteristics of papular-purpuric gloves and socks syndrome consist of a purpuric erythema affecting the hands and feet in a gloves and stocking distribution. It is sometimes associated with fever and oral lesions. The disease is self-limiting and resolves within 1 to 2 weeks. Serological studies have shown that there is an association with parvovirus B19 infection in most patients affected by this syndrome. We report a case of gloves and socks syndrome in a 21-year-old female. She had a 4-day history of papular-purpuric eruptions of the hands and feet in a gloves-and-socks distribution. She also complained of fever(up to 39C) during the first 2 or 3 days of clinical onset. The oral mucosa was normal and there were no palpable lymph nodes. Laboratory and histopathological findings were non-specific. However, human parvovirus B19 DNA was detected in the serum by a polymerase chain reaction. Systemic manifestations were transient and disappeared within a few days, whereas the skin lesions resolved gradually over a period of 2 weeks.
DNA ; Erythema ; Female ; Fever ; Foot ; Hand ; Humans ; Lymph Nodes ; Mouth Mucosa ; Parvovirus ; Parvovirus B19, Human ; Polymerase Chain Reaction ; Skin ; Young Adult

BACKGROUND: The pathogenic human parvovirus B19 replicates only in erythroid progenitor cells. The blood-group P antigen has been reported to be the cellular receptor of this virus. Human parvovirus B19 is known to be the etiologic agent of erythema infectiosum and causes a chronic anemia resulting from a persistent infection in immunocompromised patients. Recently, it has been re-ported to play a role in rheumatoid arthritis activity (RA). This study was aimed to determine whether human parvovirus B19 has a role to play in chronic anemia of RA which is the case in immunocompromised patients. We also investigated the association between the activity of the disease in RA and human parvovirus B19 infections. METHODS: Of 107 patients that had RA, 49 patients had anemia and 58 patients did not. We used ESR and CRP results to estimate the degree of disease activity. Thirty-eight patients having RA had a normal ESR and 69 patients had a high ESR. Sixty patients had normal CRP and 47 patients had high CRP. Sera of patients were tested for the presence of anti-human parvovirus B19 (IgG and IgM) using ELISA (Biotrin, Co. Dublin, Ireland). RESULTS: Of 107 patients who had RA, 79.4% (85/107) and 3.7% (4/107) were positive for IgG and IgM, respectively. There were no statistical differences between RA patients with anemia and those without anemia in the anti-human parvovirus B19 test (P>0.05). There were also no statistical differences between patients that had a normal or high ESR/CRP ratio (P>0.05). CONCLUSIONS: Human parvovirus B19 did not play a role in the formation of the chronic anemia of RA which is different from the cases of immunocompromised patients. Furthermore, we found no association between disease activity in RA and human parvovirus B19 infections.
Anemia* ; Arthritis, Rheumatoid* ; Enzyme-Linked Immunosorbent Assay ; Erythema Infectiosum ; Erythroid Precursor Cells ; Humans* ; Immunocompromised Host ; Immunoglobulin G ; Immunoglobulin M ; Parvovirus ; Parvovirus B19, Human*

BACKGROUND: As apheresis platelet concentrates are widely used recently, the risk of transfusion associated infections is increased. Parvovirus B19 causes transfusion associated infections especially in chronic hemolytic anemia, haemophilia or immunosuppressed patients. We evaluated the significance of Parvovirus B19 antigen test to be one of the apheresis platelet donor screening test. METHODS: Three hundred forty eight serum (or plasma) samples from apheresis platelet donors were tested for Parvovirus B19 antigen test which was based on haemagglutination in gel technology. The tubes arranged in special gel cards (DiaMed) were added with 25 microL P antigen positive red cell and 10 microL patient's serum and then centrifuged at room temperature, 85 g for 10 minutes without incubation. The result was read and scored from 0 to 4 positive. Also the antibody screening test was performed for all of the positive samples on the Parvovirus B19 gel card test to exclude false positive reaction due to red cell alloantibody. We investigated directed recipient's disease state for all of positive donors and compared the result of the Parvovirus B19 antigen test with the routine screening test. RESLUTS: Six of the 348 samples were positive for Parvovirus B19 antigen test, the frequency was 1.7%. All of the six positive samples on gel card test reveal negative result by the antibody screening test. All of four directed recipients are immunosuppressed states. If the Parvovirus B19 antigen test was included in routine screening test, the rejection rate is expected to be increased about 1.4%. CONCLUSION: Screening for Parvovirus B 19 in apheresis platelet donors is considered to prevent transfusion mediated viral infection of susceptible recipients including immunocompromised patients.
Anemia, Hemolytic ; Blood Component Removal* ; Blood Platelets* ; Donor Selection ; False Positive Reactions ; Hemophilia A ; Humans ; Humans* ; Immunocompromised Host ; Mass Screening* ; Parvovirus ; Parvovirus B19, Human* ; Tissue Donors*