title: Parvovirus B19 induced lupus-like syndrome with nephritis.
abstract: We report a case of a 65-year-old man who developed an acute illness with fever, arthralgia and nephritic syndrome. Antinuclear antibodies were slightly positive and complement levels were low. Renal biopsy showed exudative diffuse proliferative endocapillary glomerulonephritis with diffuse immunoglobulin (IgG, IgA, IgM) and complement deposition (C3d, C4d, C1q) on immunofluorescence. The patient was first treated with corticosteroids and mycophenolate mofetil for suspected lupus with WHO class IV glomerulonephritis. The diagnosis was questioned and a diagnosis of parvovirus B19-associated nephritis was made based on elevation of serum IgM antibodies for parvovirus B19 and detection of parvovirus B19 DNA on renal biopsy. The immunosuppressive treatment was stopped and progressive spontaneous regression of clinical and laboratory abnormalities was observed. We conclude that human parvovirus B19 infection should be considered as a cause of lupus-like symptomatology and acute glomerulonephritis.
authors.affiliation: a Department of Internal Medicine , Catholic University of Louvain , Brussels , Belgium.|b Nephrology Department , CSL Vivalia , Arlon , Belgium.
authors.forename: Elodie
authors.initials: E
authors.lastname: Georges
authors.affiliation: b Nephrology Department , CSL Vivalia , Arlon , Belgium.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Rihova
authors.affiliation: c Laboratories Synlab Genetics Ltd. , Prague , Czech Republic.
authors.forename: Radek
authors.initials: R
authors.lastname: Cmejla
authors.affiliation: b Nephrology Department , CSL Vivalia , Arlon , Belgium.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Decleire
authors.affiliation: b Nephrology Department , CSL Vivalia , Arlon , Belgium.
authors.forename: Corinne
authors.initials: C
authors.lastname: Langen
mesh_terms: D000208:Acute Disease; D000368:Aged; D001327:Autoimmune Diseases; D001706:Biopsy; D004279:DNA, Viral / Q000032:analysis*; D005921:Glomerulonephritis / Q000188:drug therapy / Q000276:immunology / Q000821:virology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007678:Kidney Glomerulus / Q000000981:diagnostic imaging*; D008297:Male; D010322:Parvoviridae Infections; D016732:Parvovirus B19, Human / Q000302:isolation & purification*; D013577:Syndrome
chemical_list: D004279:DNA, Viral; D007166:Immunosuppressive Agents
keywords: Glomerulonephritis; Human parvovirus B19; Lupus-like syndrome; Systemic lupus erythematosus