Parvovirus B19 IgM Antibodies Research Articles

Adolesan Çağındaki Çocuklarda Otoimmün Tiroiditte Parvovirus B19’un Rolü

Objective: This study aims to determine the triggering role of parvovirus B19 (PV-B19) in the pathogenesis of autoimmune thyroiditis in adolescence.Materials and Methods: Thirty-five patients aged 10-18 years who were diagnosed with Hashimoto's thyroiditis in the last 6 months were included in the study. As the control group, 35 healthy volunteers without PV-B19 associated acute disease, no goiter in physical examination, no family history of thyroid disease, and normal thyroid function tests were recruited. Serum samples were tested for PV-B19 IgM and IgG antibodies and PV-B19 DNA. Statistical analysis was performed using the SPSS.Results: PV-B19 IgM antibodies were positive in 4 (11.4%) patients and 5 (14.3%) controls whereas PV-B19 IgG antibodies were present in 13 (37.1%) patients and 6 (17.1%) controls. PV-B19 DNA was detectable in 11.4% of patients (n:4) and 14.3% of controls (n:5). There was no significant difference between the patient and control groups in terms of antibody and polymerase chain reaction positivity. In logistic regression analysis, free thyroxine level (p:0.021), anti-thyroid peroxidase antibody level (p:0.005), and isthmus thickness (p:0.021) were found to be effective on PV-B19 IgG positivity.Conclusion: Previous PV-B19 infections may be one of the triggers in the pathogenesis of Hashimoto’s thyroiditis.

SEROPREVALENCE OF HUMAN PARVOVIRUS B19 IgM AND IgG AMONG ASYMTOMATIC DONORS IN LAGOS, NIGERIA

Human parvovirus B19 is one of the emerging transfusion transmitted infections. Infection with B19 is widespread. There are limited data concerning Nigerian donors with B19 in spite of implications of such a dearth of data on health policy formation. The aim of the present study was to establish the seroprevalence of parvovirus B19 IgG and IgM antibodies among healthy blood donors in Lagos, Nigeria. Blood samples were collected between October-December 2012 from 170 asymptomatic healthy donors between ages of 20-54 years and screened for IgG and IgM antibodies using recombinant enzyme linked immunorsorbent assay kits (r-biopharm Diagnostics, Darmstadt, Germany). Net prevalence of IgM and IgG antibodies to human parvovirus B19 in this study was 65(37.6%) and 106(61.3%) respectively. A total of 39(22.9%) out of 173 blood donors screened in this research had anti- B19 antibodies (dual positivity) in their sera. Age had no statistically significant effect on anti-B19 seroprevalence among donors screened. The prevalence of parvovirus B19 among healthy donors in our study is high, and may pose adverse transfusion risk among the recipients of blood and blood products who have no detectable antibodies to parvovirus B19. This work therefore recommends routine screening for parvovirus B19 IgM antibody in blood meant for transfusion and accompanying clinical management of positive cases should be made compulsory for all donors.

A case of severe multi-system disease in a sickle cell SC patient caused by parvovirus B19 infection

Sickle Cell Disease (SCD) is an inherited hemoglobinopathy, which results in production of abnormal hemoglobin S. HbSC disease is a variant of SCD, which shares a similar clinical complication profile to HbSS disease, but often thought to be a milder condition. In patients with SCD, Hb S in deoxygenated state undergoes polymerization, leading to hemolysis, vaso-occlusive events, and eventually end-organ damage. Among other complications in patients with SCD is increased risk of complications caused by parvovirus B19. We present a case of a 14-year-old female with HbSC disease who presented to the emergency room with complaint of abdominal pain and found to have splenic sequestration. Splenic sequestration progressed rapidly, Hemoglobin (hb) dropped to 4.6 g/dl and acute chest syndrome (ACS) developed. She was treated following the ACS protocol, received 4 units of Packed Red Blood Cells (PRBC) and subsequently underwent a single volume PRBC exchange transfusion. Considering her unusual presentation, with severe ARDS from alveolar hemorrhage requiring mechanical ventilation and multi-organ injury, several autoimmune and infectious conditions with a cytokine storm component including COVID-19 disease, were considered. Results of viral testing revealed parvovirus B19 IgM antibodies signifying an acute infection. She fully recovered with supportive care and was discharged home. Multisystem involvement simulating connective tissue disorders or malignancies with acute parvovirus B19 infection has been reported and is considered extremely rare. To our knowledge, there were no reports of pediatric patients with SC disease presenting with splenic sequestration and ACS in the setting of parvovirus B19 multisystem disease. Keywords: sickle cell disease; acute respiratory distress syndrome; acute chest syndrome; parvovirus B19.

A STUDY ON THE DETAILED DESCRIPTION OFFIFTH DISEASE& MYSTERY REGARDING THE NON-PHARMACOLOGICAL TREATMENT OFFIFTH DISEASE

Fifth disease is a mild rash illness, caused due to parvovirus B19. This will be mainly seen in children compare to adults. Other names for this include: ErythemaInfectiosum (EI), Slapped cheek syndrome. Epidemics of erythema infectiosum mainly occurs in late winter or early spring. Tests for this include specific parvovirus B19 IgM antibody. IgM antibodies usually founds within 7 to 10 days of virus exposure, the remain measures are from 2 to 3 months after exposure to virus. Symptoms mainlyincludes rash, headache, fatigue, low-grade fever. However,there is no vaccine or medicine that prevent parvovirus B19 infection. Adults who have symptoms of joint pain and swelling may need rest, to alter their activities. Andtake Nonsteroidal anti-inflammatory drugs like Aspirin, Ibuprofen, or Naproxen sodium. Patients who are suffering with chronic parvovirus arthritis occasionally benefit from drugs such as hydroxychloroquine and corticosteroids and also, they want to avoid dairy products, Sweets and sugar. They want to increase their fluid intake and vitamin c supplements to improve their immune system.

P034 Parvovirus B19 infection causing vasculitis and hypocomplementemia

Abstract Background/Aims Acquired hypocomplementemia occurs through immune complex-mediated diseases, as seen in systemic lupus erythematosus (SLE), idiopathic membranoproliferative glomerulonephritis (MPGN) and cryoglobulinemia. Infective causes are less common, although chronic bacterial and viral infections causing glomerulonephritis (GN) and vasculitis have been reported. Bacterial infections causing chronic osteomyelitis, endocarditis and visceral abscesses have all been implicated, whilst hepatitis B is the only virus known to cause severe GN/ vasculitis leading to low complement levels. Severe meningococcal disease is an established cause of acquired hypocomplementemia, typically associated with Nisseria Meningitidis. Parvovirus B19 is an infection exclusive to humans, usually manifesting as fifth disease, a mild illness characterised by a rash, fever and runny nose. Less common systemic effects include hydrops fetalis, thrombocytopenia, neutropenia, neurological sequalae (including encephalopathy, aseptic meningitis, neuropathy and neuralgic amyotrophy), myocarditis and hepatitis. Arthropathy is by far the most common manifestation in adults, affecting 60% of females and 30% of males. Methods The literature on Parvovirus B19 and hypocomplementemia is sparse, limited to case reports and comparative studies, the pathogenicity of which stems from glomerulonephritis, consequently resulting in low complement levels. We present a case series of 2 patients with Parvovirus B19 infection and acquired hypocomplementemia between 2016-2020. Results Patient A, a 26-year-old female, presented with a vasculitic rash on her legs and arthralgia affecting her hands and knees, refractory to oral prednisolone and hydroxychloroquine. She was found to have low complement levels (C3 0.61 g/l and C4 0.03 g/l), whilst ANA, ENA and ANCA testing was negative. She also had a negative rheumatoid factor and anti-CCP antibody, and a normal serum protein: creatinine (6 mg/mmol). Immunoglobulins were within normal range (IgG 8.7 g/l, IgA 0.80 g/l, IgM 2.41 g/l) and a serum protein electrophoresis was normal. Hepatitis and HIV serology was also negative. Patient B, a 34-year-old female, 9 weeks pregnant, presented with polyarthralgia, fever and a maculopapular rash, with normal inflammatory markers and a normal serum protein: creatinine (9 mg/mmol). Her complement was low (C3 0.57 g/l and C4 <0.02 g/l), ANA weakly positive, ENA negative and her ANCA screen showed a pANCA pattern with positive anti-PR3 antibodies (4.6 U/ml). She also had weakly positive dsDNA antibodies (37 IU/ml), and smooth muscle antibodies were weakly positive on tissue biopsy. Anti-C1q antibodies were normal. IgM was raised (2.56 g/l), whilst IgG and IgA were normal (10.8 g/l and 1.37 g/l, respectively). Serum protein electrophoresis was normal. HIV, hepatitis B and syphilis serology was all negative. In both cases, Parvovirus B19 IgM antibody was detected. Conclusion We recommend that clinicians consider acute viral illness in patients presenting with vasculitis and hypocomplementemia. If diagnosis and treatment can be established early, patients can avoid the need for long term immunosuppression. Disclosure A. Gharatya: None. C. Nelson: None. S. Melath: None.

Human parvovirus B19 IgM antibodies among blood donor in Basra..

Human parvovirus B19 IgM antibodies among blood donor in Basra..

Seroprevalence of parvovirus B19 IgG and IgM antibodies among pregnant women in Oyo State, Nigeria

Human parvovirus B19 causes a wide range of complications in pregnant women including abortion, severe fetal anemia, non-immune hydrops fetalis, and even intrauterine fetal death. However, there is a dearth of information on the prevalence of the virus among pregnant women in southwestern Nigeria. Blood samples were collected from 231 pregnant women and screened for antibodies to human parvovirus B19 IgM and IgG using an enzyme immunosorbent assay kits. Of the 231 women, 31 were in their first trimester, 146 were in their second trimester, and 54 were in their third trimester. Forty-five (20%) were positive for parvovirus B19 IgG antibodies, 10 (4%) were positive for parvovirus B19 IgM antibodies, and 176 (76%) had no detectable parvovirus B19 antibodies. Twenty-eight (19%) of the 146 pregnant women in their second trimester were positive for parvovirus B19 IgG antibody while three (2%) of the 146 were positive for parvovirus B19 IgM antibody. It is evident that there is a high prevalence of human parvovirus B19 among pregnant women in south-western Nigeria. This suggests that there is an active transmission of the virus in the community; it is therefore necessary to conduct more studies on the virus in pregnant women in Nigeria to ascertain its effect on the fetus.

Prevalence of parvovirus B 19 infection in children with aplastic anemia

We studied the prevalence of parvovirus B19 infection in pediatric patients with acquired aplastic anemia. Detection of parvovirus B19 DNA by PCR and IgM antibodies by ELISA was carried out in 66 pediatric patients with acquired aplastic anemia. 45 healthy children acted as controls. Parvovirus B19 DNA was detected in significantly higher number of patients in comparison to controls (27% vs 2%, P = 0.001). Similarly, parvovirus B19 IgM antibodies were detected in 17 (25.8%) patients as against one control (2.2%) (P<0.05). Clinical and hematological profile of the patients with or without parvovirus infection was comparable.

Parvovirus B19: Evaluation of Incidence, Prevalence and Risk Factors among Pregnant Women Attending Ante-Natal Clinic in Nasarawa State, North Central of Nigeria

Trans-placental transmission of parvovirus B19 during pregnancy has been reported as one of the leading causes of non-immune fetal hydrops, spontaneous abortion or intra-uterine fetal death. We therefore set out to determine the presence of parvovirus B19 (Ig G and IgM) antibodies and their risk factors among pregnant wo men attending ante-natal clin ic, at Federal Medical Center, Keffi, Nasarawa State, Nigeria.A total of 273 pregnant women (Age range 15-40 years) participated after informed consent and clearance fro m the research ethics committee. Each filled a self-ad ministered questionnaire and donated blood samples between January and August 2012. A reco mbinant parvovirus B19 IgM and Ig G ELISA kit fro m DeMediTec (USA) was used for the assays.Of the 273 participants, 36 (13.2 %) had IgM antibodies, while 75 (27.5%) had Ig G antibodies with those aged 15-20 and 36-40 years having the highest incidence and prevalence rates. Being a house wife, having more ch ild ren and histories of blood transfusion, miscarriage and still b irth were associated with infection (P < 0.05).The study reveals high incidence and prevalence of parvovirus B19 infect ion among the pregnant women. The presence of parvovirus B19 IgM antibody particularly in the first and second trimesters of pregnancy poses the danger of likely trans placental transmission leading to spontaneous abortion and intra-uterine fetal death.

Parvovirus B19 in Solid Organ Transplant Recipients

Parvovirus B19 is a common, ubiquitous human pathogen.It is a small, single-stranded linear, nonenveloped DNAvirus classified into three different genotypes (genotype1, Au and Wi strains; genotype 2, LaLi and A6 strains; andgenotype 3, V9 strains). Its worldwide genetic variability islow, and there is no clear correlation between genotypeand distinctive clinical manifestation. Parvovirus B19 repli-cates most efficiently and preferentially in human erythro-cyte precursors; thus, the virus is classified as a memberof the Erythrovirus genus of the Parvoviridae family. Mostpeople are infected between the ages of 5 and 15 years;by adulthood, up to 80% are seropositive (1). Infection ap-pears to confer lifelong immunity to immunocompetenthosts, but reinfection is possible in a minority of cases(2). It has been hypothesized that Parvovirus B19 can per-sist in the bone marrow and other tissues (3), support-ing possible reactivation rather than reinfection in certainseropositive patients. Parvovirus B19 infection can be ei-ther symptomatic or asymptomatic, depending on the age,hematologic and immunologic status of the host. Whilemostpatientsrecollectonlynonspecificflu-likesymptoms,distinctive clinical entities have been associated with Par-vovirus B19 infection in both immunocompetent hosts (4)and solid organ transplant (SOT) recipients (5). The mostcommonclinicalmanifestationsofParvovirusB19aresum-marizedinTable1.Although large, prospective surveillance studies are lack-ing, earlier studies reported an incidence of Parvovirus B19disease of

Human Parvovirus B19

Human Parvovirus B19

Parvovirus B19 in the acute arthropathies and juvenile rheumatoid arthritis.

To evaluate the prevalence of recent parvovirus B19 infection in a cohort of children presenting with acute arthropathy and to determine the prevalence of a subsequent diagnosis of juvenile rheumatoid arthritis in this cohort. In this prospective study, parvovirus B19 IgM antibody was investigated in 75 patients who were referred to our clinic with acute joint complaints and also in 75 healthy controls. One patient in each group was excluded due to neuroblastoma and acute lymphoblastic leukaemia. The characteristics of parvovirus B19 IgM positive patients who were accepted as parvovirus B19 arthropathy were further evaluated. All the patients were followed up for at least 6 weeks and the patients with chronic progression of joint complaints were followed for at least 6 months to determine their progress. The cases of juvenile rheumatoid arthritis in this chronic group were identified. Parvovirus B19 IgM was detected in 16 of 74 patients (21.6%) with acute arthropathy compared with 3 of 74 (4.1%) in the healthy control group (chi(2) = 8.67; P = 0.003). The parvovirus B19 positive patients with arthropathy were more likely to become chronic (P = 3.7 x 10(-7)) and to be diagnosed as juvenile rheumatoid arthritis (P = 0.03) than the parvovirus B19 IgM negative group with arthropathy. Additional joint destruction developed in one case who was parvovirus B19 IgM positive in whom juvenile rheumatoid arthritis was diagnosed during follow up. These data support the hypothesis that parvovirus B19 infection may be associated with the onset of juvenile rheumatoid arthritis in a proportion of patients.

A study by means of a new assay of the relationship between an outbreak of erythema infectiosum and non-immune hydrops fetalis caused by human parvovirus B19

An enzyme-linked immunosorbent assay (ELISA), used to detect IgG and IgM antibody specific for human parvovirus B19, was established by use of human parvovirus B19 capsid protein VP-1 expressed in Escherichia coli. Paired samples of serum derived from 44 mothers and single samples derived from 24 babies having unexplained non-immune hydrops fetalis (NIHF), were tested by means of the assay. Five cases (11%) of NIHF were suspected of having been induced by intrauterine human parvovirus B19 infection because the samples of maternal serum were positive for parvovirus B19 IgM antibody. Four of the five cases arose during an outbreak of erythema infectiosum. According to our study and previous reports over 90% of NIHF caused by parvovirus B19 intrauterine infection have become clinically overt in the second trimester of pregnancy during a period ranging from 15 to 27 weeks of gestation.

A report of human parvovirus B19 infection in hydrops fetalis

To present the first Australian cases of fetal hydrops induced by parvovirus B19. Autopsies on two cases of intrauterine fetal death with hydrops fetalis and pallor revealed evidence of myocarditis and widespread characteristic inclusion-bearing cells, predominantly erythroblasts. The diagnosis of hydrops fetalis induced by parvovirus B19 was confirmed in both cases by immunohistological localisation of the viral inclusions by means of a monoclonal antibody to the VP1 and VP2 proteins of parvovirus B19. A low level of parvovirus B19 IgM antibodies was detected in the second case. It is possible that our relatively small population and lack of familiarity with the histopathological features may have led to underdiagnosis rather than a true absence of fetal parvovirus B19 infection in Australia. The condition can be diagnosed and treated antenatally and therefore should be included in the differential diagnosis of causes of hydrops fetalis.