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Spectrum of adult Parvovirus B19 infection according to the underlying predisposing condition and proposals for clinical practice
Author(s) -
Wolfromm Alice,
Rodriguez Christophe,
Michel Marc,
Habibi Anoosha,
Audard Vincent,
Benayoun Emmanuel,
Rogier Olivier,
Challine Dominique,
Chosidow Olivier,
Lelièvre JeanDaniel,
Chevalier Xavier,
Le Bras Fabien,
Pautas Cécile,
Imbert Michèle,
Pawlotsky JeanMichel,
WagnerBallon Orianne
Publication year - 2015
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13421
Subject(s) - parvovirus , pancytopenia , medicine , serology , polymerase chain reaction , immunology , pure red cell aplasia , antibody , disease , erythema infectiosum , parvoviridae , bone marrow , virus , biology , biochemistry , gene
Summary The virological diagnosis of Parvovirus B19 (PvB19) infection is currently based on sero‐diagnosis, molecular methods or both, yet without clear recommendations. We retrospectively identified patients with polymerase chain reaction‐positive PvB19 and/or positive serological assay between 2007 and 2013. Eighty‐two adults with at least one diagnostic criterion of recent PvB19 infection (IgM antibodies, viral DNA in blood and/or in marrow) were included and classified into three homogeneous groups: 30 patients had no underlying predisposing condition, 25 a hereditary haemolytic anaemia, 27 an underlying immunodeficiency. The classical PvB19‐related manifestations were less frequent in immunocompromised than in immunocompetent patients (arthromyalgia: 5 vs. 14; erythema: 4 vs. 17, respectively). Only 41·4% of patients with no underlying disease were anaemic. Bicytopenia and pancytopenia were observed mainly in immunocompromised patients. Classical pure red cell aplasia was observed in only 9 of the 27 marrow smears performed. Specific IgM were found in 93% of immunocompetent patients, whereas only 58% had detectable viral DNA in blood. IgM and DNA were present alone or together in all patients with hereditary haemolytic anaemia. In immunocompromised patients, the diagnosis was confirmed by marrow analysis in 91% of cases. We make some proposals based on this large series of PvB19‐infected patients.