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J Pediatr Infect Dis 2023; 18(06): 295-301
DOI: 10.1055/s-0043-1772160
Original Article

Hematological and Extra-Hematological Manifestations of Parvovirus B19 Disease

Cengiz Zeybek 
1   Department of Pediatric Nephrology, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Türkiye
,
Ahmet Bolat
2   Department of Pediatrics, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Türkiye
,
Orhan Gürsel
3   Department of Pediatric Hematology, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Türkiye
,
İbrahim Eker
4   Department of Pediatric Hematology, Faculty of Medicine, Kocatepe University, Afyon, Türkiye
,
Ahmet Emin Kürekçi
5   Department of Pediatric Hematology, Lösante Hospital, Ankara, Türkiye
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Abstract

Objective Parvovirus B19 (PVB19) is a virus that can present with many hematological and extra-hematological findings. Its prognosis is relatively good in immunocompetent patients, but severe disease may develop in immunocompromised patients. We retrospectively reviewed a series of children who presented with PVB19 during a 6-year period at our institution.

Methods Nine children with positive polymerase chain reaction and serological test results for PVB19 were studied. Their demographic data, atypical clinical and laboratory findings, treatment regiments, clinical course, and prognosis were noted.

Results The hematological abnormalities associated with PVB19 were anemia, neutropenia, and thrombocytopenia, and the extra-hematological abnormalities were systemic lupus erythematosus-like syndrome, hemophagocytic lymphohistiocytosis, and acute kidney injury. All patients had good outcomes with no significant sequelae.

Conclusion This case review suggests that clinicians should not consider PVB19 only as a cause of hematological events; they should also be alert to the possibility that it may cause extra-hematological diseases.

Keywords

parvovirus B19 - hematological - extrahematological


Publikationsverlauf

Eingereicht: 14. März 2023

Angenommen: 07. Juli 2023

Artikel online veröffentlicht:
31. Juli 2023

© 2023. Thieme. All rights reserved.

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  • References

  • 1 Cossart YE, Field AM, Cant B, Widdows D. Parvovirus-like particles in human sera. Lancet 1975; 1 (7898) 72-73
    CrossrefPubMedGoogle Scholar
  • 2 Landry ML. Parvovirus B19. Microbiol Spectr 2016; . (e-pub ahead of print). DOI: 10.1128/microbiolspec.DMIH2-0008-2015.
    CrossrefPubMedGoogle Scholar
  • 3 Heegaard ED, Brown KE. Human parvovirus B19. Clin Microbiol Rev 2002; 15 (03) 485-505
    CrossrefPubMedGoogle Scholar
  • 4 Brown KE. Detection and quantitation of parvovirus B19. J Clin Virol 2004; 31 (01) 1-4
    CrossrefPubMedGoogle Scholar
  • 5 Henter J-I, Horne A, Aricó M. et al. HLH-2004: diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer 2007; 48 (02) 124-131
    CrossrefPubMedGoogle Scholar
  • 6 McClain K, Estrov Z, Chen H, Mahoney Jr DHJ. Chronic neutropenia of childhood: frequent association with parvovirus infection and correlations with bone marrow culture studies. Br J Haematol 1993; 85 (01) 57-62
    CrossrefPubMedGoogle Scholar
  • 7 Hanada T, Koike K, Hirano C. et al. Childhood transient erythroblastopenia complicated by thrombocytopenia and neutropenia. Eur J Haematol 1989; 42 (01) 77-80
    CrossrefPubMedGoogle Scholar
  • 8 Kurtzman GJ, Gascon P, Caras M, Cohen B, Young NS. B19 parvovirus replicates in circulating cells of acutely infected patients. Blood 1988; 71 (05) 1448-1454
    CrossrefPubMedGoogle Scholar
  • 9 Ozawa K, Ayub J, Kajigaya S, Shimada T, Young N. The gene encoding the nonstructural protein of B19 (human) parvovirus may be lethal in transfected cells. J Virol 1988; 62 (08) 2884-2889
    CrossrefPubMedGoogle Scholar
  • 10 Srivastava A, Bruno E, Briddell R. et al. Parvovirus B19-induced perturbation of human megakaryocytopoiesis in vitro. Blood 1990; 76 (10) 1997-2004
    CrossrefPubMedGoogle Scholar
  • 11 Heegaard ED, Rosthøj S, Petersen BL, Nielsen S, Karup Pedersen F, Hornsleth A. Role of parvovirus B19 infection in childhood idiopathic thrombocytopenic purpura. Acta Paediatr 1999; 88 (06) 614-617
    CrossrefPubMedGoogle Scholar
  • 12 von dem Borne AE, Bos MJ, Joustra-Maas N. et al. A murine monoclonal IgM antibody specific for blood group P antigen (globoside). Br J Haematol 1986; 63 (01) 35-46
    CrossrefPubMedGoogle Scholar
  • 13 Rouger P, Gane P, Salmon C. Tissue distribution of H, Lewis and P antigens as shown by a panel of 18 monoclonal antibodies. Rev Fr Transfus Immunohematol 1987; 30 (05) 699-708
    CrossrefPubMedGoogle Scholar
  • 14 Moffatt S, Yaegashi N, Tada K, Tanaka N, Sugamura K. Human parvovirus B19 nonstructural (NS1) protein induces apoptosis in erythroid lineage cells. J Virol 1998; 72 (04) 3018-3028
    CrossrefPubMedGoogle Scholar
  • 15 Meyer O. Parvovirus B19 and autoimmune diseases. Joint Bone Spine 2003; 70 (01) 6-11
    CrossrefPubMedGoogle Scholar
  • 16 Inoue S, Kinra NK, Mukkamala SR, Gordon R. Parvovirus B-19 infection: aplastic crisis, erythema infectiosum and idiopathic thrombocytopenic purpura. Pediatr Infect Dis J 1991; 10 (03) 251-253
    CrossrefPubMedGoogle Scholar
  • 17 Valentin MN, Cohen PJ. Pediatric parvovirus B19: spectrum of clinical manifestations. Cutis 2013; 92 (04) 179-184
    PubMedGoogle Scholar
  • 18 Saeki T, Shibuya M, Sawada H. et al. Human parvovirus B19 infection mimicking systemic lupus erythematosus. Mod Rheumatol 2001; 11 (04) 308-313
    CrossrefPubMedGoogle Scholar
  • 19 Meyer O, Kahn MF, Grossin M. et al. Parvovirus B19 infection can induce histiocytic necrotizing lymphadenitis (Kikuchi's disease) associated with systemic lupus erythematosus. Lupus 1991; 1 (01) 37-41
    CrossrefPubMedGoogle Scholar
  • 20 Trapani S, Ermini M, Falcini F. Human parvovirus B19 infection: its relationship with systemic lupus erythematosus. Semin Arthritis Rheum 1999; 28 (05) 319-325
    CrossrefPubMedGoogle Scholar
  • 21 Illescas-Montes R, Corona-Castro CC, Melguizo-Rodríguez L, Ruiz C, Costela-Ruiz VJ. Infectious processes and systemic lupus erythematosus. Immunology 2019; 158 (03) 153-160
    CrossrefPubMedGoogle Scholar
  • 22 Henter JI, Tondini C, Pritchard J. Histiocyte disorders. Crit Rev Oncol Hematol 2004; 50 (02) 157-174
    CrossrefPubMedGoogle Scholar
  • 23 Bal A, Mishra B, Singh N, Das A, Jindal SK. Fulminant parvovirus B19-associated pancarditis with haemophagocytic lympho-histiocytosis in an immunocompetent adult. APMIS 2009; 117 (10) 773-777
    CrossrefPubMedGoogle Scholar
  • 24 Ardalan MR, Shoja MM, Tubbs RS, Esmaili H, Keyvani H. Postrenal transplant hemophagocytic lymphohistiocytosis and thrombotic microangiopathy associated with parvovirus b19 infection. Am J Transplant 2008; 8 (06) 1340-1344
    CrossrefPubMedGoogle Scholar
  • 25 Shirono K, Tsuda H. Parvovirus B19-associated haemophagocytic syndrome in healthy adults. Br J Haematol 1995; 89 (04) 923-926
    CrossrefPubMedGoogle Scholar
  • 26 Kerr JR, Cunniffe VS, Kelleher P, Coats AJ, Mattey DL. Circulating cytokines and chemokines in acute symptomatic parvovirus B19 infection: negative association between levels of pro-inflammatory cytokines and development of B19-associated arthritis. J Med Virol 2004; 74 (01) 147-155
    CrossrefPubMedGoogle Scholar
  • 27 Moffatt S, Tanaka N, Tada K. et al. A cytotoxic nonstructural protein, NS1, of human parvovirus B19 induces activation of interleukin-6 gene expression. J Virol 1996; 70 (12) 8485-8491
    CrossrefPubMedGoogle Scholar
  • 28 Maakaroun NR, Moanna A, Jacob JT, Albrecht H. Viral infections associated with haemophagocytic syndrome. Rev Med Virol 2010; 20 (02) 93-105
    CrossrefPubMedGoogle Scholar
  • 29 Larroche C, Scieux C, Honderlick P, Piette AM, Morinet F, Blétry O. Spontaneous resolution of hemophagocytic syndrome associated with acute parvovirus B19 infection and concomitant Epstein-Barr virus reactivation in an otherwise healthy adult. Eur J Clin Microbiol Infect Dis 2002; 21 (10) 739-742
    CrossrefPubMedGoogle Scholar
  • 30 Orth HM, Fuchs A, Lübke N, Jensen BO, Luedde T. Recurrent parvovirus B19 viremia resulting in two episodes of hemophagocytic lymphohistiocytosis. Virol J 2022; 19 (01) 107
    CrossrefPubMedGoogle Scholar
  • 31 Kauffmann M, Bobot M, Daniel L. et al. Parvovirus B19 infection and kidney injury: report of 4 cases and analysis of immunization and viremia in an adult cohort of 100 patients undergoing a kidney biopsy. BMC Nephrol 2020; 21 (01) 260
    CrossrefPubMedGoogle Scholar
  • 32 Besse W, Mansour S, Jatwani K, Nast CC, Brewster UC. Collapsing glomerulopathy in a young woman with APOL1 risk alleles following acute parvovirus B19 infection: a case report investigation. BMC Nephrol 2016; 17 (01) 125
    CrossrefPubMedGoogle Scholar
  • 33 Marco H, Guermah I, Matas L. et al. Postinfectious glomerulonephritis secondary to Erythrovirus B19 (Parvovirus B19): case report and review of the literature. Clin Nephrol 2016; 85 (04) 238-244
    CrossrefPubMedGoogle Scholar
  • 34 Moudgil A, Nast CC, Bagga A. et al. Association of parvovirus B19 infection with idiopathic collapsing glomerulopathy. Kidney Int 2001; 59 (06) 2126-2133
    CrossrefPubMedGoogle Scholar
  • 35 Magro CM, Crowson AN, Dawood M, Nuovo GJ. Parvoviral infection of endothelial cells and its possible role in vasculitis and autoimmune diseases. J Rheumatol 2002; 29 (06) 1227-1235
    PubMedGoogle Scholar
  • 36 Prasad B, St Onge J. Parvovirus leading to thrombotic microangiopathy in a healthy adult. BMJ Case Rep 2016; 2016: bcr2015213492
    CrossrefPubMedGoogle Scholar
  • 37 Görkem A, Uğur AR, Özdemir M, Feyzioğlu B, Baykan M. Investigation of parvovirus B19 IgM and IgG positivity rates in pediatric hematology patients. J Pediatr Infect Dis 2018; 13 (04) 274-276
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 38 Anderson MJ, Higgins PG, Davis LR. et al. Experimental parvoviral infection in humans. J Infect Dis 1985; 152 (02) 257-265
    CrossrefPubMedGoogle Scholar
  • 39 Lindblom A, Heyman M, Gustafsson I. et al. Parvovirus B19 infection in children with acute lymphoblastic leukemia is associated with cytopenia resulting in prolonged interruptions of chemotherapy. Clin Infect Dis 2008; 46 (04) 528-536
    CrossrefPubMedGoogle Scholar
  • 40 Holterhus M, Hennies M, Hillmann H. et al. Parvovirus B19 infection in pediatric allogeneic hematopoietic cell transplantation—single-center experience and review. Transpl Infect Dis 2023; 25 (02) e14028
    CrossrefPubMedGoogle Scholar