Spectrum of adult Parvovirus B19 infection according to the underlying predisposing condition and proposals for clinical practice.
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.
Département d'Hématologie et d'Immunologie Biologiques, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.
Alice
A
Wolfromm
Département de Virologie, Bactériologie-Hygiène, Mycologie-Parasitologie, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.|INSERM U955, Créteil, France.
Christophe
C
Rodriguez
Service de Médecine interne, National Referral Centre For Adult Immune Cytopenias, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.
Marc
M
Michel
Unité des Maladies Génétiques du Globule Rouge, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.
Anoosha
A
Habibi
INSERM U955, Créteil, France.|Service de Néphrologie et de Transplantation, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.
Vincent
V
Audard
Département d'Hématologie et d'Immunologie Biologiques, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.
Emmanuel
E
Benayoun
Département de Virologie, Bactériologie-Hygiène, Mycologie-Parasitologie, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.
Olivier
O
Rogier
Département de Virologie, Bactériologie-Hygiène, Mycologie-Parasitologie, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.
Dominique
D
Challine
Service de Dermatologie, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.|French satellite of the Cochrane Skin Group, Créteil, France.|Centre d'Investigation Clinique 006, INSERM, Créteil, France.
Olivier
O
Chosidow
INSERM U955, Créteil, France.|Service d'Immunologie clinique et Maladies infectieuses, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.
Jean-Daniel
JD
Lelièvre
Service de Rhumatologie, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.
Xavier
X
Chevalier
Unité Fonctionnelle d'Hémopathies lymphoïdes, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.
Fabien
F
Le Bras
Service d'Hématologie clinique, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.
Cécile
C
Pautas
Département d'Hématologie et d'Immunologie Biologiques, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.
Michèle
M
Imbert
Département de Virologie, Bactériologie-Hygiène, Mycologie-Parasitologie, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.|INSERM U955, Créteil, France.
Jean-Michel
JM
Pawlotsky
Département d'Hématologie et d'Immunologie Biologiques, Hôpital Henri Mondor, APHP, UPEC, Créteil, France.|INSERM U955, Créteil, France.
Orianne
O
Wagner-Ballon
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000745:Anemia, Hemolytic, Congenital / Q000150:complications; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D019468:Disease Management; D004198:Disease Susceptibility; D016731:Erythema Infectiosum / Q000150:complications / Q000175:diagnosis* / Q000821:virology*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D016732:Parvovirus B19, Human / Q000235:genetics*; D012189:Retrospective Studies; D055815:Young Adult
anaemia; human parvovirus B19; pure red cell aplasia; underlying predisposing condition