Life‐Threatening Parvovirus B19–Associated Myocarditis and Cardiac Transplantation as Possible Therapy: Two Case Reports

Enders, Gisela; Dötsch, J.; Bauer, JA; Nützenadel, W.; Hengel, Hartmut; Haffner, Darrah; Schalasta, Gunnar; Searle, Karen; Brown, Kevin E.

doi:10.1086/516295

Cited by 71 publications

(39 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among these are hydrops fetalis [Anderson et al, 1988], acute and chronic arthritis [Reid et al, 1985;Naides et al, 1990;Biasi et al, 1996], acute and persistent aplastic anemia, thrombocytopenia, pancytopenia [Chorba et al, 1986;Young, 1988;Srivastava et al, 1990] and persistent infections in immunocompromised patients [Flunker et al, 1998] and also rarely in immunocompetent individuals [Cassinotti et al, 1993]. Recent case reports on B19-associated hepatitis [Hillingso et al, 1998;Pardi et al, 1998], myocarditis [Orth et al, 1997;Enders et al, 1998], and encephalitis [Umene and Nuone, 1995] have shown the increasing diversity of symptoms that can arise during B19 infections.…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence of parvovirus B19 NS1-specific IgG in B19-infected and uninfected individuals and in infected pregnant women

Hemauer

Gigler

Searle³

et al. 2000

J. Med. Virol.

View full text Add to dashboard Cite

Parvovirus B19 is the causative agent of erythema infectiosum in children, but the virus is associated with an increasing range of different diseases. These include acute and chronic arthritis, hydrops fetalis in pregnant women, aplastic anemia, and thrombocytopenia. The host's immune response is directed against the viral structural proteins VP1 and VP2. This study investigated the presence of IgG against the viral nonstructural protein NS1 using Western blot. Serum panels from healthy individuals, B19-infected pregnant women, and various disease groups were tested. The disease groups included patients with symptoms that may be linked to parvovirus B19 infection. The results showed that IgG against the NS1 protein was present in 22% of healthy individuals with past B19 infection. In cases of persistent or prolonged B19 infections, the prevalence of NS1-specific antibodies was as high as 80%. It is concluded that NS1-specific IgG may be used as an indicator of chronic or more severe courses of parvovirus B19 infections.

show abstract

Section: Introductionmentioning

confidence: 99%

Seroprevalence of parvovirus B19 NS1-specific IgG in B19-infected and uninfected individuals and in infected pregnant women

Hemauer

Gigler

Searle³

et al. 2000

J. Med. Virol.

View full text Add to dashboard Cite

show abstract

“…Several studies disclosed an association between B19 and a variety of diseases (43,48,63,80), such as arthritis (56, 77), vasculitic syndromes (19, 24, 31, 80), hepatitis (27,36,38,75,85), and neurological disorders (2, 85). Specifically, B19 infections have been observed to be associated with acute and chronic myocarditis (13,16,30,44,53,(58)(59)(60)71). Moreover, the development of endothelial and isolated left ventricle diastolic dysfunction has been associated with B19 infection (81).…”

mentioning

confidence: 99%

Phospholipase A2 Activity-Dependent Stimulation of Ca ²⁺ Entry by Human Parvovirus B19 Capsid Protein VP1

Lupescu¹,

Bock

Lang

et al. 2006

J Virol

View full text Add to dashboard Cite

Recent reports demonstrated an association of human parvovirus B19 with inflammatory cardiomyopathy (iCMP), which is accompanied by endothelial dysfunction. As intracellular Ca 2؉ activity is a key regulator of cell function and participates in mechanisms leading to endothelial dysfunction, the present experiments explored the effects of the B19 capsid proteins VP1 and VP2. A secreted phospholipase A2 (PLA2)-like activity has been located in the VP1 unique region of the B19 minor capsid protein. As PLA2 has recently been shown to activate the store-operated or capacitative Ca 2؉ channel I CRAC , we analyzed the impact of the viral PLA2 motif on Ca 2؉ entry. We cloned the VP1 and VP2 genes isolated from a patient suffering from fatal B19 iCMP into eukaryotic expression vectors. We also generated a B19 replication-competent plasmid to demonstrate PLA2 activity under the control of the complete B19 genome. After the transfection of human endothelial cells (HMEC-1), cytosolic Ca Human parvovirus B19, a nonenveloped virus of about 22 to 24 nm in diameter, is a member of the genus Erythrovirus within the family of Parvoviridae (35). B19 infection occurs frequently in humans, and this is documented by the high prevalence of specific immunoglobulin G (IgG) antibodies in young children (5% to 15%), adults (60%), and seniors older than 69 years (85%) (15). B19 is the causative agent of erythema infectiosum (fifth disease), hydrops fetalis, and transient aplastic anemia (1,86). Several studies disclosed an association between B19 and a variety of diseases (43,48,63,80), such as arthritis (56, 77), vasculitic syndromes (19, 24, 31, 80), hepatitis (27,36,38,75,85), and neurological disorders (2, 85). Specifically, B19 infections have been observed to be associated with acute and chronic myocarditis (13,16,30,44,53,(58)(59)(60)71). Moreover, the development of endothelial and isolated left ventricle diastolic dysfunction has been associated with B19 infection (81). During pregnancy, parvovirus B19 infection may cause maternal and fetal myocarditis, congenital abnormalities, stillbirth, and abortion (10, 21, 39, 61). The particularly severe course of the antenatal disease may relate to the preference of B19 for proliferating tissues (79).The cellular receptor for B19 infection has been regarded as a blood group P antigen based on the failure of B19 infection in a patient with a hereditary P antigen defect (12). The P antigen is necessary for B19 binding but not sufficient for virus entry into cells. In this regard, the ␣5␤1 integrin and the recently identified Ku80 autoantigen act as cellular coreceptors for human parvovirus B19 infection (57, 82). Therefore, target cells of B19 are mainly erythroid progenitor cells expressing high levels of P antigen as well as the coreceptors ␣5␤1 integrin and Ku80 autoantigen. However, nonerythroid cell lineages, such as fetal myocytes, follicular dendritic cells, and endothelial cells can be infected by B19 (12,28,29,57,82). We have recently localized B19 genomes in endothelial cells of my...

show abstract

“…Parvovirus B19 is the causative agent of erythema infectiosum, also called fifth disease. Parvovirus B19 infection has been reported to be a rare but severe cause of myocarditis in infants and children (7,11,13). HHV-6 is the causative agent of exanthema subitum, also called sixth disease.…”

mentioning

confidence: 99%

Fatal Myocarditis Associated with Acute Parvovirus B19 and Human Herpesvirus 6 Coinfection

et al. 2001

View full text Add to dashboard Cite

We report on the case of a healthy young boy who developed a fulminant myocarditis due to acute coinfection with erythrovirus (parvovirus B19) and human herpesvirus 6 (HHV-6) in the absence of an antiviral immune response. We suggest that the HHV-6-induced immunosuppression enhanced dissemination of parvovirus B19, which led to fatal myocarditis. CASE REPORTAn 11-year-old boy was admitted with a 3-day history of fever that progressed within a few hours to acute distress. He had no notable medical history; in particular, there were no signs of a preexisting immunodeficiency. On examination he was lethargic and cyanotic with tachypnea and had a fever (41.3°C). His blood pressure was 73/31 mm Hg, and his pulse was 201 beats/min. Erythema and exudates on the tonsils were noted, as were cervical lymphadenopathies and a rash involving both arms and the neck. Examination of the head, lungs, and abdomen was normal. There were no focal neurological signs. He was intubated. Intravenous dopamine and dobutamine were given. Arterial blood gas analysis showed a pH of 7.26 and partial O 2 pressure of 3.48 kPa, with an O 2 saturation level of 43.4%. Cardiac arrest occurred suddenly; resuscitation efforts were successful only for a short time, and the patient died of congestive heart failure 55 min later.Biochemical laboratory findings were normal except for Creactive protein (64.5 mg/liter; normal level, Ͻ10 mg/liter), creatinine kinase (6.60 kat/liter; normal level, 0.10 to 3.17 kat/liter), and troponin T (0.59 ng/ml; normal level, Ͻ0

show abstract

Life‐Threatening Parvovirus B19–Associated Myocarditis and Cardiac Transplantation as Possible Therapy: Two Case Reports

Cited by 71 publications

References 8 publications

Seroprevalence of parvovirus B19 NS1-specific IgG in B19-infected and uninfected individuals and in infected pregnant women

Seroprevalence of parvovirus B19 NS1-specific IgG in B19-infected and uninfected individuals and in infected pregnant women

Phospholipase A2 Activity-Dependent Stimulation of Ca ²⁺ Entry by Human Parvovirus B19 Capsid Protein VP1

Fatal Myocarditis Associated with Acute Parvovirus B19 and Human Herpesvirus 6 Coinfection

Contact Info

Product

Resources

About

Life‐Threatening Parvovirus B19–Associated Myocarditis and Cardiac Transplantation as Possible Therapy: Two Case Reports

Cited by 71 publications

References 8 publications

Seroprevalence of parvovirus B19 NS1-specific IgG in B19-infected and uninfected individuals and in infected pregnant women

Seroprevalence of parvovirus B19 NS1-specific IgG in B19-infected and uninfected individuals and in infected pregnant women

Phospholipase A2 Activity-Dependent Stimulation of Ca 2+ Entry by Human Parvovirus B19 Capsid Protein VP1

Fatal Myocarditis Associated with Acute Parvovirus B19 and Human Herpesvirus 6 Coinfection

Contact Info

Product

Resources

About

Phospholipase A2 Activity-Dependent Stimulation of Ca ²⁺ Entry by Human Parvovirus B19 Capsid Protein VP1