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parvovirus B19

Tuesday 13 July 2004

Definition: Parvovirus B19 (PVB19) is the causative agent of erythema infectiosum and sometimes the infection is correlated with severe haematological complications, or in pregnancy to fetalis hydrops.

Images

Fetal parvovirus B-19 infection.Erythroid precursors contain ground-glass nuclear inclusions

Physiopathology

Moreover some authors suggest an infection involvement in some autoimmune diseases. Infection with parvovirus B19 (B19) has been associated with connective tissue disease (CTD) stigmata, namely, a systemic lupus erythematosus (SLE)-like illness, seronegative polyarthritis resembling rheumatoid arthritis, and vasculitis.

Parvovirus B19 is the only known human pathogenic parvovirus with a high degree of tropism to human bone marrow and replicates only in erythroid progenitor cells. In patients with underlying hemolytic disorder, infection with parvovirus B19 causes transient aplastic crisis. In immunosuppressed patients, the infection may cause pure red cell aplasia and chronic anemia. Diagnosis is based on examination of bone marrow and serologic confirmation. In normal patients, parvovirus B19 infection is often associated with neutropenia and thrombocytopenia.

The cellular receptor for parvovirus B19 is a neutral glycosphingolipid called globaside, found on erthyroid progenitors. A giant proerythroblast, 25-32 µm in diameter with a large eosinophilic nuclear inclusion body is the characterisitic finding. IgM antibody to B19 appears 10-14 days after infection.

Pathology

acute Parvovirus B19 infection mimicking myelodysplastic syndrome