Neurological aspects of human parvovirus B19 infection: A systematic review

Reviews in Medical Virology (Impact Factor: 5.57). 05/2014; 24(3). DOI: 10.1002/rmv.1782
Source: PubMed


Parvovirus B19 has been linked with various clinical syndromes including neurological manifestations. However, its role in the latter remains not completely understood. Although the last 10 years witnessed a surge of case reports on B19-associated neurological aspects, the literature data remains scattered and heterogeneous, and epidemiological information on the incidence of B19-associated neurological aspects cannot be accurately extrapolated. The aim of this review is to identify the characteristics of cases of B19-associated neurological manifestations. A computerized systematic review of existing literature concerning cases of B19-related neurological aspects revealed 89 articles describing 129 patients; 79 (61.2%) were associated with CNS manifestations, 41 (31.8%) were associated with peripheral nervous system manifestations, and 9 (7.0%) were linked with myalgic encephalomyelitis. The majority of the cases (50/129) had encephalitis. Clinical characteristic features of these cases were analyzed, and possible pathological mechanisms were also described. In conclusion, B19 should be included in differential diagnosis of encephalitic syndromes of unknown etiology in all age groups. Diagnosis should rely on investigation of anti-B19 IgM antibodies and detection of B19 DNA in serum or CSF. Treatment of severe cases might benefit from a combined regime of intravenous immunoglobulins and steroids. To confirm these outcomes, goal-targeted studies are recommended to exactly identify epidemiological scenarios and explore potential pathogenic mechanisms of these complications. Performing retrospective and prospective and multicenter studies concerning B19 and neurological aspects in general, and B19 and encephalitic syndromes in particular, are required. © 2014 The Authors. Reviews in Medical Virology published by John Wiley & Sons, Ltd.

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    • "A new member of the genus Copiparvovirus, horse parvovirus CSF, was sequenced here from the CSF of a horse with neurological deficits and lymphocytic pleocytosis. Human parvovirus B19 and PARV4 have previously been reported in the CSF of patients with encephalitis (Barah et al., 2014;Benjamin et al., 2011;Douvoyiannis et al., 2009;Prakash et al., 2015). The detection of a novel parvovirus in the CSF in this animal may therefore be related to its neurological signs or reflect increased blood–brain barrier permeability. "
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    ABSTRACT: Metagenomics was used to characterize viral genomes in clinical specimens of horses with various organ-specific diseases of unknown etiology. A novel parvovirus as well as a previously described hepacivirus closely related to human hepatitis C virus and equine herpesvirus 2 were identified in the cerebrospinal fluid of horses with neurological signs. Four co-infecting picobirnaviruses, including an unusual genome with fused RNA segments, and a divergent anellovirus were found in the plasma of two febrile horses. A novel cyclovirus genome was characterized from the nasal secretion of another febrile horse. Lastly, a small circular DNA genome with a Rep gene, from a virus we called kirkovirus, was identified in the liver and spleen of a horse with fatal idiopathic hepatopathy. This study expands the number of viruses found in horses and characterizes their genomes to assist future epidemiological studies of their transmission and potential association with various equine diseases.
    Full-text · Article · Jun 2015 · Journal of General Virology
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    • "Clinical characteristics of PVB19-related encephalitis are not specific; therefore, PVB19 testing should be considered in the workup of encephalitic syndromes, since it can be done routinely in clinical laboratories. We agree with previous authors [11] [14] that detection of PVB19 should be incorporated in the differential diagnosis of encephalitis cases, regardless of the age. This case also shows the importance of second sample testing for correct interpretation of serology results and suggests to be more critical face to first findings. "
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    ABSTRACT: •We described a case of severe encephalitis in an immunocompetent teenager.•Initial virological results pointed unconvincingly to an EBV primary infection.•Parvovirus B19 infection was discovered by chance, as etiology of the encephalitis.•Parvovirus B19 testing should be included in the workup of encephalitis.
    Full-text · Article · Dec 2014 · Journal of Clinical Virology
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    ABSTRACT: Objective: Our aim was to describe the epidemiologic, clinical, and laboratory characteristics of acute parvovirus B19 infection in adults. Material and methods: This study describes all cases of acute parvovirus B19 infection in patients older than 18 years of age who were treated at Hospital Universitario La Paz in Madrid, Spain, in 2012. Results: Forty-nine adults were treated for acute parvovirus B19 infection. Most were young women who were infected in the spring or early summer. In over half the cases skin lesions were key diagnostic signs.We saw the full range of types of rash of purplish exanthems that were fairly generalized; vasculitis was relatively common (in >18%). Mild or moderate abnormalities in blood counts and indicators of liver dysfunction resolved spontaneously in all but 2 immunocompromised patients, who developed chronic anemia. Conclusions: This is the largest case series of acute parvovirus B19 infection published to date. This infection should be suspected on observing signs of purplish skin rashes, no matter the location or pattern of distribution, or vasculitis, especially if accompanied by fever and joint pain in young women in the spring. Measures to avoid infection should be recommended to individuals at risk.
    No preview · Article · Aug 2014 · Actas Dermo-Sifiliográficas
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