Fetal anaemia: diagnosis and management

Brennand, Janet; Cameron, Alan

doi:10.1016/j.bpobgyn.2007.08.005

Cited by 33 publications

(40 citation statements)

References 80 publications

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“…Fetal anemia and hydrops may be due to immune conditions such red-cell or Kell alloimmunization or non-immune hydrops due to hPV B19. The diagnosis and management of fetal anemia and hydrops in general has been reviewed elsewhere 88. Hydrops fetalis associated with hPV B19 infection was first reported in 1984 53.…”

Section: Clinical Findingsmentioning

confidence: 99%

Parvovirus B19 infection in human pregnancy

Lamont

Sobel

Vaisbuch

et al. 2010

BJOG

170

139

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Human parvovirus B19 infection is widespread. Approximately 30-50% of pregnant women are nonimmune, and vertical transmission is common following maternal infection in pregnancy. Fetal infection may be associated with a normal outcome, but fetal death may also occur without ultrasound evidence of infectious sequelae. B19 infection should be considered in any case of nonimmune hydrops. Diagnosis is mainly through serology and polymerase chain reaction.Surveillance requires sequential ultrasound and Doppler screening for signs of fetal anaemia, heart failure and hydrops. Immunoglobulins, antiviral and vaccination are not yet available, but intrauterine transfusion in selected cases can be life saving.

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Section: Clinical Findingsmentioning

confidence: 99%

Parvovirus B19 infection in human pregnancy

Lamont

Sobel

Vaisbuch

et al. 2010

BJOG

170

139

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“…Although clinical response is common as evidenced by reticulocytosis, increased hemoglobin levels, and decline in serum viral DNA, a complete eradication of viremia may, however, not occur in some patients, particularly in transplant patients, who are highly immunosuppressed. Thus, relapses of anemia can occur up to several months after completion of treatment (Brennand and Cameron, 2008). Repeated administration of IVIG may be helpful, but some patients experience multiple relapses (Moudgil et al, 1997;Brennand and Cameron, 2008).…”

Section: Treatmentmentioning

confidence: 99%

“…Thus, relapses of anemia can occur up to several months after completion of treatment (Brennand and Cameron, 2008). Repeated administration of IVIG may be helpful, but some patients experience multiple relapses (Moudgil et al, 1997;Brennand and Cameron, 2008). Reduction of immunosuppressive medication is often recommended in addition to IVIG (or without IVIG in less severe cases) to allow the patient's own immune response to mature and neutralize the virus (Bertoni et al, 1997;Lamont et al, 2011).…”

Section: Treatmentmentioning

confidence: 99%

Human parvovirus B19: A review

Rogo¹,

Mokhtari‐Azad²,

Kabir³

et al. 2014

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Summary. -Parvovirus B19 (B19V) is a small non-enveloped single-stranded DNA (ssDNA) virus of the family Parvoviridae, the subfamily Parvovirinae, the genus Erythrovirus and Human parvovirus B19 type species. It is a common community-acquired respiratory pathogen without ethnic, socioeconomic, gender, age or geographic boundaries. Moreover, the epidemiological and ecological relationships between human parvovirus B19, man and environment have aroused increasing interest in this virus. B19V infection is associated with a wide spectrum of clinical manifestations, some of which were well established and some are still controversial, however, it is also underestimated from a clinical perspective. B19V targets the erythroid progenitors in the bone marrow by binding to the glycosphingolipid globoside (Gb4), leading to large receptor-induced structural changes triggering cell death either by lysis or by apoptosis mediated by the nonstructural (NS)1 protein. The pattern of genetic evolution, its peculiar properties and functional profile, the characteristics of its narrow tropism and restricted replication, its complex relationship with the host and its ample pathogenetic potential are all topics that are far from a comprehensive understanding. The lack of efficient adaptation to in vitro cellular cultures and the absence of animal models have limited classical virological studies and made studies on B19V dependent on molecular biology. The present review looks at the nature of this virus with the view to provide more information about its biology, which may be useful to the present and future researchers.Keywords: human parvovirus B19; respiratory pathogen; biology; genome; fifth disease; transient aplastic crisis; anemia * Corresponding author. E-mail: rezaie@tums.ac.ir; phone: +982188982343. Abbreviations: B19V = parvovirus B19; Gb4 = glycosphingolipid globoside; IL-6 = interleukin 6; IVIG = intravenous immunoglobulin G; MHC = major histocompatibility class; SF3-helicase = superfamily 3 helicase; NS = nonstructural; TNF-α = tumor necrosis factor α; VLPs = virus like particles; VP1 = viral protein 1; VP2 = viral protein 2

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“…Transfusions are required to treat the anemia in cases of transient aplastic crisis or prolonged anemia, while in cases of arthralgias, nonsteroidal anti-inflammatory drugs may exert beneficial effects. In cases of fetal infections and hydrops, intrauterine transfusions are indicated when the hemoglobin concentration in the fetal circulation falls below a threshold level, and case series report improved survival rates of hydropic fetuses [231,340].…”

Section: Screening and Blood Products' Safetymentioning

confidence: 99%

Parvovirus B19 Achievements and Challenges

Gallinella

2013

ISRN Virology

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Parvovirus B19 is a widespread human pathogenic virus, member of the Erythrovirus genus in the Parvoviridae family. Infection can be associated with an ample range of pathologies and clinical manifestations, whose characteristics and outcomes depend on the interplay between the pathogenetic potential of the virus, its adaptation to different cellular environments, and the physiological and immune status of the infected individuals. The scope of this review is the advances in knowledge on the biological characteristics of the virus and of virus-host relationships; in particular, the interactions of the virus with different cellular environments in terms of tropism and ability to achieve a productive replicative cycle, or, on the contrary, to establish persistence; the consequences of infection in terms of interference with the cell physiology; the process of recognition of the virus by the innate or adaptive immune system, hence the role of the immune system in controlling the infection or in the development of clinical manifestations. Linked to these issues is the continuous effort to develop better diagnostic algorithms and methods and the need for development of prophylactic and therapeutic options for B19V infections.

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Fetal anaemia: diagnosis and management

Cited by 33 publications

References 80 publications

Parvovirus B19 infection in human pregnancy

Parvovirus B19 infection in human pregnancy

Human parvovirus B19: A review

Parvovirus B19 Achievements and Challenges

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