Haemophagocytic lymphohistiocytosis (HLH) is a clinico-pathologic entity caused by increased proliferation and activation of benign macrophages with haemophagocytosis throughout the reticulo-endothelial system. Virus-associated HLH is a well-recognised entity. Although majority of parvovirus B19 associated HLH does not require any specific treatment and carries good prognosis, outcome of children is worse than adults. We report here a case of HLH associated with acute parvovirus B19 infection in a young healthy patient with underlying hereditary spherocytosis, with bone marrow findings typical of parvovirus infection. Although this patient had spontaneous recovery of cell counts, he succumbed due to complication from prolonged ventilation. Unexpectedly, his immunoglobulin levels were inappropriately normal despite on-going ventilator associated pneumonia, which reflects inadequate humoral immune response towards infection.
Parvovirus

No abstract available.
Acute Generalized Exanthematous Pustulosis* ; Parvovirus*

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*

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

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: 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*

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 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*

Oral rabies vaccination (ORV) program for the wild animals in rabies risk regions of Korea has been conducted since 2000. Evaluation of ORV program under field condition and information concerning the incidence of exposure to canine distemper and canine parvovirus (CPV) are needed in wild raccoon dogs (Nyctereutes procyonoides koreensis). Ninety four sera of wild raccoon dogs were screened for antibodies against rabies, canine distemper virus (CDV) and CPV in Korea. The overall prevalence of antibodies against rabies virus (RABV), CDV and CPV in wild raccoon dogs was 35.1%, 89.4% and 24.5%, respectively. Comparisons of sero-prevalences of RABV, CDV and CPV were assayed in two regions (Gyeonggi-do and Gangwon-do). The Gyeonggi-do (36.4%) showed higher sero-positive rate against CPV than Gangwon-do (20.8%). In contrast, Gangwon-do (41.7% and 97.2%) showed higher sero-positive rates against RABV and CDV than Gyeonggi-do (13.6% and 63.6%). These results indicate that there was severe circulation of CDV and CPV among wild raccoon dogs in the two regions of Korea. Furthermore, raccoon dogs showing a protective antibody titer (0.5 IU/ml) were 15.9%, suggesting that new rabies control program such as trap-vaccination-release (TVR) should be launched urgently in rabies risk regions.
Animals ; Animals, Wild ; Antibodies ; Distemper ; Distemper Virus, Canine ; Incidence ; Korea ; Parvovirus ; Parvovirus, Canine ; Prevalence ; Rabies ; Rabies virus ; Raccoon Dogs ; Raccoons ; Vaccination

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