title: [Clinical and biological manifestations in primary parvovirus B19 infection in immunocompetent adult: a retrospective study of 26 cases].
abstract: OBJECTIVE
  Parvovirus B19 causes erythema infectiosum in children, transient aplastic anemia in patients with hemoglobinopathies, pur red cell aplasia in immunocompromised persons and hydrops fetalis in pregnancy. The spectrum of clinical and biological manifestations in immunocompetent adult continues to grow up.
  
  
  METHODS
  We report on a case series of 26 patients with primary parvovirus B19 infection in immunocompetent adults. This is a retrospective study over the period 2000 to 2010 in two departments of internal medecine. The diagnostic was clinical, serological or molecular.
  
  
  RESULTS
  There was a female predominance (sex-ratio 3.33/1). Median patient age at diagnostic was 38.8 years (range: 18-68). The predominant symptoms were fever (65%), peripheral and symmetrical polyarthralgia (62%) and skin rash (58%). Two patients had neurological manifestations (sixth cranial nerve palsy, distal paresthesia) and one patient had myocarditis. Abnormal laboratory values included increased acute phase reactants (73%), thrombocytopenia (43%), lymphopenia (38%) and elevated liver enzymes (37%). Antinuclear (19%), anti-DNA (28%) and anti-phospholipids antibodies (14%), and hypocomplementemia (32%) were observed. False reaction with anti-CMV and anti-EBV IgM positivity was documented in 27% of cases. Two patients had persistent parvovirus B19 infection.
  
  
  CONCLUSIONS
  The diversity of the clinical manifestations of parvovirus B19 infection may be misleading for the clinician. However, the diagnosis should be suspected in immunocompetent adults to limit the risk of transmission to the patients who could develop a severe infection such as pregnant women or immunocompromised patients.
authors.affiliation: Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, Grande-Rue-de-la-Croix-Rousse, 69317 Lyon cedex 04, France; Faculté de médecine Lyon-Sud Charles-Mérieux, université Claude-Bernard Lyon-1, 69495 Lyon, France. Electronic address: danyroof@hotmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Parra
authors.affiliation: Laboratoire de virologie, centre de biologie et de pathologie Est, hospices civils de Lyon, 69677 Bron, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Mekki
authors.affiliation: Service de médecine interne, centre hospitalier Lyon-Sud, hospices civils de Lyon, 69495 Pierre-Bénite, France.
authors.forename: I
authors.initials: I
authors.lastname: Durieu
authors.affiliation: Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, Grande-Rue-de-la-Croix-Rousse, 69317 Lyon cedex 04, France; Faculté de médecine Lyon-Sud Charles-Mérieux, université Claude-Bernard Lyon-1, 69495 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Broussolle
authors.affiliation: Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, Grande-Rue-de-la-Croix-Rousse, 69317 Lyon cedex 04, France; Faculté de médecine Lyon-Sud Charles-Mérieux, université Claude-Bernard Lyon-1, 69495 Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Sève
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015551:Autoimmunity; D005260:Female; D006801:Humans; D007121:Immunocompetence; D008297:Male; D008875:Middle Aged; D010322:Parvoviridae Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology / Q000628:therapy*; D016732:Parvovirus B19, Human / Q000472:pathogenicity; D012189:Retrospective Studies; D055815:Young Adult
keywords: Adult; Adulte; Auto-anticorps; Autoantibodies; Immunocompetent; Immunocompétent; Lupus; Parvovirus B19