NATURAL HISTORY OF CONGENITAL PARVOVIRUS B19 INFECTION: SEROLOGIC RESPONSES IN ASYMPTOMATIC INFANTS • 728

Parvovirus B19 infection is undiagnosed in recipients undergoing solid organ transplantation. It is usually responsible for unexplained acute and chronic red blood cell aplasia that does not respond to erythropoietin therapy. Cases of parvovirus B19 infection associated with pancytopenia, solid organ dysfunction, and allograft rejection have been described in the literature. The deterioration of the immune system as a result of severe immunotherapy favors the reactivation of a previous infection or the acquisition of a new one. We present a case of a 32-year-old woman with a 1-year history of renal allograft transplant and previous cytomegalovirus (CMV) infection who presented with chest pain, polyarthritis, pancytopenia, and renal dysfunction. A serum sample using polymerase chain reaction showed a parvovirus titer of 13.8 trillion IU/mL and a CMV titer of 800 IU/mL. The renal biopsy revealed nucleomegaly with focal viral inclusions, along with changes associated with immunotherapy toxicity. Electron microscopy demonstrated capillary and tubular epithelial cells with “viral factories,” thereby confirming the diagnosis. Thus, screening for parvovirus B19 is advised in high-risk patients who present with refractory anemia to avoid the complications of a chronic infection associated with the fatal rejection of the transplanted organ.

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Parvovirus

10.1093/med/9780190604813.003.0012 ◽

2018 ◽

Author(s):

Amol Purandare ◽

Barbara A. Jantausch

Keyword(s):

Parvovirus B19 ◽

Antiviral Agents ◽

Neurodevelopmental Outcome ◽

Congenital Infection ◽

Future Research ◽

Fetal Anemia ◽

Intrauterine Transfusion ◽

History Of ◽

Parvovirus B19 Infection ◽

Neurodevelopmental Impairment

Parvovirus B19 is a common infection in humans that occurs worldwide. Parvovirus B19 is transmitted through exposure to respiratory droplets, blood, and blood products, and through mother-to-child transmission (MTCT) in utero. Intrauterine parvovirus B19 infection is a rare occurrence during pregnancy but can result in significant morbidity and mortality for the fetus, including severe fetal anemia and nonimmune fetal hydrops (NIFH). Intrauterine transfusion can be successful in treating fetal anemia. Neurodevelopmental impairment has been reported in infants with congenital infection who have received intrauterine transfusion (IUT). Future research on the development of antiviral agents for the treatment of parvovirus B19 infection in pregnant women is needed, along with the development of a parvovirus B19 vaccine. Longitudinal studies to evaluate neurodevelopmental outcome of infants with a history of congenital parvovirus B19 infection are needed in order to facilitate the optimal evaluation and management of these infants.

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Current epidemiological aspects of human parvovirus B19 infection during pregnancy and childhood in the western part of Germany

Epidemiology and Infection ◽

10.1017/s095026880600731x ◽

2006 ◽

Vol 135 (4) ◽

pp. 563-569 ◽

Cited By ~ 33

Author(s):

M. ENDERS ◽

A. WEIDNER ◽

G. ENDERS

Keyword(s):

Young Adults ◽

Risk Factor ◽

Pregnant Women ◽

Parvovirus B19 ◽

Major Risk Factor ◽

Human Parvovirus B19 ◽

History Of ◽

Parvovirus B19 Infection ◽

Specific Igg ◽

Children And Young Adults

SUMMARYThis investigation was undertaken to provide detailed information on the epidemiology of human parvovirus B19 (B19) infection during pregnancy and childhood in the western part of Germany. Between 1997 and 2004, 40 517 sera from pregnant women aged 17–45 years and 6060 sera from children and young adults were tested for B19 IgG and IgM in our laboratory. In pregnant women, both the history of a ‘specific’ (OR 7·7, 95% CI 5·2–11·4) and a ‘non-specific’ rash (OR 3·3, 95% CI 1·5–7·1) was predictive for B19 IgM positivity. The B19 IgG prevalence was 69·2% (4097/5924) in a subgroup of asymptomatic pregnant women screened for B19 antibodies. In children, the age-specific IgG-positivity rate increased from 12·2% (66/541) at 2 years of age to 71·9% (396/551) in those older than 10 years. In conclusion, the prevalence of B19 IgG in pregnant women from the western part of Germany is higher then previously reported. Contact with children aged 3–10 years is a major risk factor for exposure to B19. Pregnant women with the history of a ‘non-specific’ rash should also be evaluated for acute B19 infection.

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Preservative Monitoring of a Greek Woman with Hydrops Fetalis due to Parvovirus B19 Infection

Case Reports in Obstetrics and Gynecology ◽

10.1155/2017/4389321 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3

Author(s):

Zacharias Fasoulakis ◽

Panagiotis Antsaklis ◽

Emmanuel N. Kontomanolis

Keyword(s):

Parvovirus B19 ◽

Hydrops Fetalis ◽

Erythroid Progenitor ◽

Fetal Demise ◽

Erythroid Progenitor Cells ◽

The Family ◽

History Of ◽

Greek Woman ◽

B19 Parvovirus ◽

Parvovirus B19 Infection

Primate erythroparvovirus 1 (parvovirus B19) is a member of theErythrovirusgenus of the Parvoviridae family and it is one of the few members of the family known to be pathogenic in human. B19 infection is common and widespread with the virus being associated with numerous rheumatologic and haematologic manifestations. More specifically, maternal infection with parvovirus B19 during pregnancy can cause severe anemia which may lead to nonimmune hydrops or fetal demise, as a result of fetal erythroid progenitor cells infection with shortened half-life of erythrocytes. We present a rare case reported in the Greek population, of subclinical transient reticulocytopenia due to B19 parvovirus infection, in an asymptomatic pregnant woman, without medical history of hemoglobinopathy, and with the presence of hydrops fetalis during the third trimester of her pregnancy.

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Symmetrical Polyarthropathy and Hepatosplenomegaly as a Manifestation of Parvovirus B-19: A Case Report

International Journal of Medical and Pharmaceutical Case Reports ◽

10.9734/ijmpcr/2021/v14i430140 ◽

2021 ◽

pp. 13-18

Author(s):

Mohamed Eltaieb Ali ◽

Ashraf Alakkad

Keyword(s):

Primary School ◽

Close Contact ◽

Parvovirus B19 ◽

School Teacher ◽

Primary School Children ◽

Primary School Teacher ◽

Causative Factors ◽

History Of ◽

Parvovirus B19 Infection ◽

Subsequent Section

This case was of a 35-years old Egyptian lady, who works as a primary school teacher, who presented to the OPD with complaints of persistent high fever for two days. Along with this fever, she also had severe pain in multiple joints of both hands, wrists, knees, and ankles. In addition, the woman also complained of having developed a rash on both her legs, which was so painful that she was unable to stand without pain. The pain was agonizing and it prevented her from performing her usual jobs as normal. But that was the extent of her symptoms. She did not complain of a cough, shortness of breath, chest pain, back pain, abdominal pain, or any other pain for that matter. In a summary, none of the factors and symptoms that could have pointed towards the patient suffering from a case of COVID19 were present. Moreover, there was no recent history of travel. She also had not contracted any gastrointestinal or genitourinary infections in the preceding few days. The clinical examination of the patient revealed no abnormalities at all. The only thing worth noting was remarkable swelling and tenderness over the metacarpophalangeal and proximal interphalangeal joints. The following series of events are discussed in detail in the subsequent section, and it was concluded that the woman might be suffering from the parvovirus B19 infection. She had several favorable causative factors that pointed toward this diagnosis, with the most important one being her in close contact with primary school children, who are most the likely age group, between five and twenty years, to carry this infection and also contract it. Adults can contract the infection from children, but the range of symptoms varies from person to person. In this case of the woman, further evaluations and investigations were needed to confirm the diagnosis, which was likely due to the obvious risk factors present in this case.

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How is the moral stance related to the intentional stance and group thinking?

Behavioral and Brain Sciences ◽

10.1017/s0140525x19002413 ◽

2020 ◽

Vol 43 ◽

Author(s):

Hannes Rakoczy

Keyword(s):

Natural History ◽

Social Cognitive ◽

Intentional Stance ◽

Cognitive Capacities ◽

Shared Intentionality ◽

History Of ◽

Group Thinking ◽

Moral Stance

Abstract The natural history of our moral stance told here in this commentary reveals the close nexus of morality and basic social-cognitive capacities. Big mysteries about morality thus transform into smaller and more manageable ones. Here, I raise questions regarding the conceptual, ontogenetic, and evolutionary relations of the moral stance to the intentional and group stances and to shared intentionality.

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