Symptoms Associated with Parvovirus B19 Infection in Adults: A Pilot Study

Waza, Kazuhiro; Inoue, Kazuo; Matsumura, Shinji

doi:10.2169/internalmedicine.46.0366

Cited by 23 publications

(13 citation statements)

References 9 publications

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“…Like these earlier studies, we found joint and cutaneous manifestations to be common and had a favourable outcome in most cases, with good response to NSAIDs [2, 4–10]. However, in our patients, joint symptoms persisted 6 months after onset in 28% of patients versus 8 to 20% in previous series [2, 5, 6, 9].…”

Section: Discussionsupporting

confidence: 81%

“…A few studies in adults have described symptoms and clinical characteristics of HPV-B19 infection [2, 4–10, 17]. Like these earlier studies, we found joint and cutaneous manifestations to be common and had a favourable outcome in most cases, with good response to NSAIDs [2, 4–10].…”

Section: Discussionsupporting

confidence: 80%

“…It was then recognized as a causative agent of erythema infectiosum, hydrops fetalis and fetal deaths, and pure red cell aplasia (PRCA) in immunocompromised patients [3]. In young adults, HPV-B19 infection is also associated with joint manifestations [2, 4–10]. …”

Section: Introductionmentioning

confidence: 99%

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Extra-haematological manifestations related to human parvovirus B19 infection: retrospective study in 25 adults

et al. 2018

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BackgroundTo describe extra-haematological manifestations associated with human parvovirus B19 (HPV-B19) infection.MethodsWe conducted a nationwide multicentre study to retrospectively describe the characteristics and outcome of extra-haematological manifestations in French adults.ResultsData from 25 patients followed from 2001 to 2016 were analysed. Median age was 37.9 years (range: 22.7–83.4), with a female predominance (sex ratio: 4/1). Only 3 patients had an underlying predisposing condition (hemoglobinopathy or pregnancy). The most common manifestations were joint (80%) and skin (60%) involvement. Four patients (16%) had renal involvement (endocapillary proliferative or membranoproliferative glomerulonephritis, focal segmental glomerulosclerosis). Three patients (12%) had peripheral nervous system involvement (mononeuritis, mononeuritis multiplex, Guillain-Barré syndrome) and 2 (8%) presented muscle involvement. Other manifestations included hemophagocytic lymphohistiocytosis (n = 1), myopericarditis and pleural effusion (n = 1), and lymphadenopathy and splenomegaly mimicking lymphoma with spleen infarcts (n = 1). Immunological abnormalities were frequent (56.5%). At 6 months, all patients were alive, and 54.2% were in complete remission. In 2 patients, joint involvement evolved into rheumatoid arthritis. Six patients (24%) received intravenous immunoglobulin (IVIg), with a good response in the 3 patients with peripheral nervous system involvement.ConclusionsHPV-B19 infection should be considered in a wide range of clinical manifestations. Although the prognosis is good, IVIg therapy should be discussed in patients with peripheral nerve involvement. However, its efficacy should be further investigated in prospective studies.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 80%

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Extra-haematological manifestations related to human parvovirus B19 infection: retrospective study in 25 adults

et al. 2018

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“…Adults with joint manifestations of parvovirus B19 infections present with symmetric small joint arthralgias or frank synovitis, myalgias, an evanescent rash, and fever (7). Although the “slapped cheek” rash is the most characteristic finding in children, cutaneous findings in adults are more common on either the upper or lower extremities (8). Up to 80% of patients infected with parvovirus B19 develop joint symptoms.…”

Section: Differential Diagnosismentioning

confidence: 99%

A 62‐year‐old man with wrist and hand pain

Setty

Robinson

2008

Arthritis & Rheumatism

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A 62-year-old man presented to the rheumatology clinic with report of bilateral wrist and hand pain. His symptoms had begun several months before, and over the preceding 2 months had become so severe that he was unable to make a fist. The patient observed that he had begun "walking like an old man" and had difficulty getting out of his car. His joint symptoms were associated with morning stiffness of more than 1 hour. The patient also reported swelling in his hands and wrists. Past medical historyHis past medical history was notable for hypertension, hypercholesterolemia, prostatic hypertrophy, and fractures of the left tibia and fibula, which he had sustained in a skiing injury. Previous surgeries had included a vasectomy, removal of a basal cell cancer from his nose, and bilateral carpal tunnel release 2 years before presentation.In addition, for at least 5 years, the patient had had persistent arthralgias of his shoulder and knees. He had taken ibuprofen, with some improvement. However, the medication caused lower extremity edema and was discontinued. He then began celecoxib.The patient believed that his shoulder symptoms had been precipitated by lifting weights. He had undergone bilateral shoulder arthroscopies within 1 year of his presentation and received the diagnosis of degenerative joint disease. At arthroscopy, the patient had undergone debridement of both glenohumeral joints, as well as the reattachment of a torn left glenoid labrum. The operative report had indicated an unremarkable synovium.Six months before presentation, the patient had developed chest pain without electrocardiogram changes. A cardiac catheterization had shown normal coronary arteries, and his symptoms were ascribed to gastroesophageal reflux. He had noted occasional bright red blood per rectum and dark stools. A colonoscopy 2 years before presentation had shown sigmoid diverticulosis and non-bleeding external hemorrhoids.The patient's medications upon presentation to the rheumatology clinic were aspirin (81 mg/day), terazosin hydrochloride (5 mg at bedtime), carvedilol (20 mg/day), and celecoxib (100 mg twice daily). He had no known drug allergies. Social and family historyThe patient was a real estate developer. He lived with his wife and 2 children. He did not smoke and drank alcohol less than 1 to 2 times a week. Review of systemsThe patient denied skin rash, photosensitivity, alopecia, oral ulcers, weight loss, numbness or tingling in the extremities, and focal motor weakness. He also denied headaches, jaw claudication, vision changes, fevers, and cough. Physical examinationThe patient was afebrile, with a blood pressure of 124/70 mm Hg and a pulse of 80 beats/minute. His pulmonary, cardiac, and abdominal examination results were normal. There were no rashes or skin lesions. However, he had boggy swelling of his bilateral proximal interphalangeal and metacarpophalangeal joints and wrists. The areas were painful to palpation, with minimal warmth and no overlying erythema. Flexion and extension in the wrist were limited by pain....

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“…Human parvovirus B19 is most known for causing erythema infectiosum in children, transient red cell aplasia which can be significant in those with hemolytic anemia or polyarthropathy in adults [1] , [2] .…”

Section: Introductionmentioning

confidence: 99%

Splenic infarcts as a rare manifestation of parvovirus B19 infection

Kranidiotis

Efstratiadis

Kapsalakis

et al. 2016

IDCases

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IntroductionHuman parvovirus B19 is a DNA virus most known for causing erythema infectiosum in children, and polyarthropathy or transient aplastic crisis in adults. However, various unusual clinical manifestations have also been reported in association with it. We describe a young patient who presented with splenic infarcts as a rare complication of B19 infection.Case reportA 33-year old previously healthy man was admitted to our hospital because of a 5-day history of fever and headache. Imaging studies revaled two splenic infarcts. Endocarditis was ruled out, whereas serologic testing for B19 was indicative of acute infection.DiscussionTo our knowledge, three cases of thromboembolism in the setting of B19 infection have been reported up to now, including one occurence of splenic infarction. These events were attributed to the development of a transient antiphospholipid antibody syndrome. In contrast, our patient did not have elevated titers of antiphospholipid antibodies.ConclusionsSplenic infarcts can be an atypical presentation of B19 infection. Parvovirus B19 may induce thromboembolic events, even in the absence of antiphospholipid antibodies.

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Symptoms Associated with Parvovirus B19 Infection in Adults: A Pilot Study

Abstract: Background and Objectives The clinical features of parvovirus B19 infection in adult patients

Cited by 23 publications

References 9 publications

Extra-haematological manifestations related to human parvovirus B19 infection: retrospective study in 25 adults

Extra-haematological manifestations related to human parvovirus B19 infection: retrospective study in 25 adults

A 62‐year‐old man with wrist and hand pain

Splenic infarcts as a rare manifestation of parvovirus B19 infection

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