Feto-Placentary Pathology in Human Parvovirus B19 Infection

Abstract

In view of the scarce references concerning the histological data in congenital parvovirus human B19 infection, we intend to provide a description of the pathological features observed in six autopsies. The virus was detected by DNA hybridization (ISH-DBH), PCR and electronmicroscopy (EM) in paraffin-embedded feto-placentary tissues. These cases constitute a subset from 86 Non Immunologic Hydrops Fetalis (NIHF) cases, in which a systemic complex of inflammatory/degenerative lesions of unknown etiology was visualized by optical microscopy. In one case a syphilitic process was detected, typefying a double infection. All fetuses showed a similar pathology--hydrops, hepato-splenomegaly, lung hypoplasia and erythroblastemia, the specific histological feature being the presence of intranuclear inclusions in the erythroid progenitors, in the erythropoietic visceral tissue and in blood marrow. Complex cardiopathy allied to abnormal lung lobulation and polisplenia were observed once; in 2 cases endocardial fibroelastosis was diagnosed. The pulmonary lesions were represented by dysmaturity allied to interstitial mononuclear infiltration. The hepatic consisted of cholestasis, portal fibrosis, canalicular proliferation, hemossiderosis, focal necroses and giant cell transformation. The central nervous system lesions were predominantly anoxic although the autolysis impaired a correct diagnosis.

Parvovirus B19 nonstructural (NS1) protein as a transactivator of interleukin‐6 synthesis: Common pathway in inflammatory sequelae of human parvovirus infections?

“…Autopsy usually reveals a leukoerythroblastic reaction in the liver characterized by large pale cells with eosinophilic viral inclusion bodies and PCR positivity for B19 genomic DNA. Although B19 is not teratogenic, congenital infection can lead to postnatal manifestations including: bone marrow depression or failure with immunodeficiency, anemia, or erythroblastemia; ocular abnormalities; meconium ileus and peritonitis; hepatosplenomegaly or hepatic disease (cholestasis, portal fibrosis, canalicular proliferation, hemosiderosis, focal necrosis, giant cell transformation); lung hypoplasia; or cardiac abnormalities [Brown, 1997;Garcia et al, 1998]. These may be associated with persistent viremia.…”

Placental Cellular Immune Response in Women Infected with Human Parvovirus B19 during Pregnancy

“…Garcia et al (7) described six cases of nonimmune hydrops fetalis due to B19. The investigators described a mononuclear cell infiltrate in the villous stroma and intervillous space in all six cases of B19 infection (7). Information on both the type of immune cells present and the inflammatory cytokines expressed in the placenta during B19 infection could provide a better understanding of the mechanism of virus transmission during pregnancy or assist in evaluating vaccines against B19 that are being developed.…”

Parvovirus as a Differential Diagnosis of Hydrops fetalis in the First Trimester

“…Furthermore, in cases of hydrops secondary to parvovirus in later pregnancy, the anaemia resulting from bone suppression leads to excessive hepatic erythropoiesis [6], which may result in portal hypertension and/or hypoproteinaemia with consequent ascites. However, it is possible that anaemia causing cardiac failure in the first trimester may cause pleural effusions and increased nuchal translucency without ascites.…”