Parvovirus B19 infection in the immunocompromised host
ABSTRACT Human parvovirus B19 is a single-stranded DNA virus with a predilection for infecting rapidly dividing cell lines, such as bone marrow erythroid progenitor cells. People with defective cell-mediated immunity (eg, severe combined immunodeficiency syndrome; acquired immunodeficiency syndrome; and patients receiving immunosuppressive therapy, ie, post organ transplant) can develop pure red cell aplasia, in which suppression of erythroid precursors is permanent. Identification of parvovirus inclusions in marrow biopsies and subsequent confirmation of infection by in situ hybridization is important in the assessment of anemia in immunodeficient patients. Our objective is to provide a general overview of the parvovirus B19 infection and its characteristics in immunocompromised patients and to summarize updated information regarding the clinicopathologic features, pathobiology, and laboratory diagnosis of this subject. The pathologist should be aware of the wide spectrum of manifestations of parvovirus B19 infection depending on the patient's hematologic and immunologic status.
- SourceAvailable from: Sotirios Papageorgiou
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- "Review of the literature indicates that approximately 1-2% of all adult solid-organ transplant recipients developed symptomatic active B19 infection during posttransplant course . Although PRCA represents the most common clinical manifestation, the spectrum of B19-associated clinical complications following transplantation is much broader and includes: (1) various cytopenias, or even aplastic anemia, (2) acute hepatic dysfunction ranging from abnormal liver biochemistry to fulminant hepatic failure, (3) myocarditis, (4) thrombotic microangiopathy , (5) chronic allograft dysfunction, or (6) respiratory failure  . B19 infection and PRCA is a rare event among allogeneic stem cell transplant (Allo-SCT) recipients. "
ABSTRACT: Parvovirus B19 is recognized as a rare cause of pure red cell aplasia (PRCA) in allogeneic stem cell (SCT) and solid organ transplant patients. We report a patient with Hodgkin's disease who developed PRCA due to parvovirus B19 after autologous SCT and who had an excellent response after treatment with gamma-globulin.06/2011; 2011:251930. DOI:10.1155/2011/251930
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ABSTRACT: Primary cutaneous T cell lymphomas (CTCL) represent a heterogeneous group of T lymphomas. Virus involvement in CTCL pathogenesis has been extensively investigated, but no data are available as to a causative role of parvovirus B19. The prevalence of parvovirus variants (B19, LaL1/K71, V9) was investigated by using two nested PCRs and a genotype-2 semiquantitative PCR (Q-PCR). Parvovirus DNA was detected in similar percentage in healthy skin controls (40%; n=42), inflammatory dermatoses (ID) (41%; n=80) and CTCL (34%; n=76). Among variants, genotype-2 was more prevalent in ID (26%) and CTCL (22%) than in normal skin (14%; p<0.05). genotype-3 was never found in normal skin and was rare in ID. The only four pathological skin samples with a quantifiable genome copies/μg DNA values in Q-PCR were ID. In conclusion, despite the skin represent a reservoir for genotype-1, parvovirus infection is not involved in the etiopathogenesis of CTCL.Archives for Dermatological Research 10/2009; 301(9):647-652. DOI:10.1007/s00403-009-0954-6 · 1.90 Impact Factor
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ABSTRACT: We report a 2-month-old infant with Parvovirus B19 infection presenting as transient myeloproliferation resembling juvenile myelomonocytic leukemia (JMML). Patient history, physical examination, and laboratory findings were suggestive of JMML. On viral serology, raised IgM and IgG titers for Parvovirus B19 infection were found in the absence of giant proerythroblasts and viral inclusions in the erythroid precursors. Follow-up showing a decrease in viral titers suggested parvovirus infection as an etiological factor for the development of myeloproliferative features. This case highlights the importance of viral serology in work-up myeloproliferative disorders of infancy and childhood.Pediatric Blood & Cancer 03/2009; 52(3):411-3. DOI:10.1002/pbc.21842 · 2.39 Impact Factor