Parvovirus-B19 and hematologic disorders
Sevgi Yetgin1, Selin Aytaç Elmas
1Department of Pediatric Hematology, Hacettepe University, Ankara, Turkey Phone: +90 312 305 11 72
Insights
Parvovirus-B19 (PV-B19) infection can cause various diseases, including erythema infectiosum and aplastic anemia. Investigating PV-B19 is crucial for unexplained hematologic disorders, especially when serology is insufficient.
Area of Science:
- Virology
- Immunology
- Hematology
Background:
- Parvovirus-B19 (PV-B19), a small DNA virus, is linked to diseases reflecting host-virus-immune system interactions.
- Manifestations include erythema infectiosum, hydrops fetalis, and red cell aplasia, affecting diverse patient groups.
- PV-B19 can present with unclear mechanisms in various systemic diseases, potentially leading to misdiagnosis.
Purpose of the Study:
- To highlight the diverse clinical presentations of Parvovirus-B19 infections.
- To emphasize the importance of considering PV-B19 in unexplained hematologic disorders.
- To discuss diagnostic challenges and therapeutic approaches for PV-B19.
Main Methods:
- Review of clinical manifestations and associations of PV-B19.
- Discussion of diagnostic limitations of serology in immunocompromised individuals.
- Highlighting polymerase chain reaction (PCR) as a diagnostic tool.
Main Results:
- PV-B19 causes a spectrum of diseases, from common childhood infections to severe hematologic conditions.
- Unexplained cytopenias and systemic diseases may be associated with PV-B19.
- PCR offers a reliable method for PV-B19 detection in serum and tissues.
Conclusions:
- Hematologic disorders with unestablished diagnoses warrant PV-B19 investigation.
- Diagnostic strategies must account for limitations in immunocompromised patients.
- Current treatments include supportive care, transfusions, and immunoglobulin; vaccination is under study.
Abstract:
Parvovirus-B19 (PV-B19) is a member of Parvoviridae, which is one of the smallest DNA viruses. PV-B19-associated diseases usually serve as a good representation of the balance of virus, host response and the immune system. The diseases manifested with PV-B19 are erythema infectiosum, which is common in children, hydrops fetalis, transient pure red cell aplasia in patients with chronic hemolytic anemia, arthralgia - mostly observed in women, and chronic pure red cell aplasia in immunocompromised individuals. Cytopenia (bicytopenia, monocytopenia or pancytopenia) may also accompany the diseases mentioned above. On the other hand, there are many diseases, including neurologic, vasculitic, hepatic, rheumatoid, nephritic, autoimmune, myocardial, and others in which the mechanisms of the diseases are not clear, which may be associated with PV-B19. The virus may manifest with unexpected and unexplained clinical pictures and lead to misdiagnosis. Therefore, hematologic disorders in any unestablished clinical diagnosis should be investigated for PV-B19 infection. However, serologic examination for PV-B19 diagnosis is not sufficient in immunocompromised status. The virus can be determined with polymerase chain reaction (PCR) in the serum or tissue samples. Supportive therapy, blood transfusion and immunoglobulin are the conventional therapeutic interventions for PV-B19 today. Vaccination studies are under examination.
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