Human Parvovirus-Associated Red Cell Aplasia in the Absence of Underlying Hemolytic Anemia

Horn, D K Van; Mortimer, Philip P.; Young, NS; Hanson, Gerald

doi:10.1097/00043426-198623000-00011

Cited by 91 publications

(25 citation statements)

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“…Our report supports the recent report by Van Horn et al 4 demonstrating human parvovirus B 19 as a cause of prolonged erythroid hypoplasia in leukemia patients on maintenance therapy. The erythroid suppression and subsequent severe anemia in our patient probably was related to prolonged B 19 infection caused by a suppressed host immunologic response secondary to chemotherapy.…”

Section: Resultssupporting

confidence: 93%

Severe Anemia Caused by Human Parvovirus in a Leukemia Patient on Maintenance Chemotherapy

Smith

Shah

Lobel

et al. 1988

Clin Pediatr (Phila)

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A 6-year-old boy on maintenance chemotherapy for acute lymphocytic leukemia developed severe hypoplastic anemia during chemotherapy previously well tolerated. The hypoplastic episode persisted for approximately 30 days. Human parvovirus (B19), the etiologic agent of aplastic crisis in persons with underlying hemolytic syndromes, was detected in the patient's serum 25-30 days after onset of hemoglobin decrease, and B19 IgM seroconversion occurred 1 week later. The patient's hypoplastic anemia was presumably caused by prolonged B19 infection resulting from a blunted immune response. An immune response to the B19 infection and resolution of the illness were temporally associated with brief cessation of chemotherapy.

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Section: Resultssupporting

confidence: 93%

Severe Anemia Caused by Human Parvovirus in a Leukemia Patient on Maintenance Chemotherapy

Smith

Shah

Lobel

et al. 1988

Clin Pediatr (Phila)

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“…Parvovirus B19 DNA was present in maternal serum and/or fetal material in 94% of cases with an IgM positive mother (34/36), in 55% of cases with an IgM borderline mother (6/11), and in 25% of cases with an IgM negative mother (1/4). Other investigators also detected parvovirus B19 DNA after IgM antibody detection had become negative by immunoassay [Van Horn et al, 1986;Kurtzman et al, 1987]. In two cases with IgM positive mothers, PCR was negative in maternal and fetal samples: fetal hydrops was due to an acute CMV infection in one of them.…”

Section: Discussionmentioning

confidence: 94%

“…In immunocompetent individuals, especially adults, it may lead to an acute arthropathy [Reid et al, 1985;White et al, 1985]. In patients with underlying hemolytic disorders, the virus can cause an aplastic crisis [Pattison et al, 1981], and in the immunocompromised host, infection becomes persistent leading to chronic anemia [Van Horn et al, 1986;Kurtzman et al, 1987]. Parvovirus B19 has also been associated with myocarditis and hepatitis [Yoto et al, 1996;Enders et al, 1998].…”

Section: Introductionmentioning

confidence: 99%

Parvovirus B19 infection in pregnancy: Quantitative viral DNA analysis using a kinetic fluorescence detection system (TaqMan PCR)

Knöll

Louwen

Kochanowski

et al. 2002

Journal of Medical Virology

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Human parvovirus B19 infections are common in the general population, and infection during pregnancy may cause hydrops fetalis and fetal death. To initiate adequate treatment, accurate laboratory diagnosis is essential. The most sensitive tests are nested PCR systems, but these assays provide semiquantitative results at best. A parvovirus B19 DNA assay was developed based on the real time TaqMan PCR. This method was calibrated on the basis of serial plasmid dilutions and tested with an international parvovirus B19 standard. The assay was capable of quantifying parvovirus B19 DNA from one to about 5 x 10(7) genome equivalents per reaction (corresponding to 100 to 5 x 10(9) genome equivalents per ml serum). Samples from 51 pregnant women with suspected acute parvovirus B19 infection were tested, and positive PCR results were obtained in at least one of the materials investigated in 41 cases. The median viral DNA load in maternal blood samples was 1.3 x 10(4) copies/ml (range 7.2 x 10(2)-2.6 x 10(7)). Maternal virus DNA concentration was not associated with the presence of maternal symptoms and/or fetal complications. As the stage of infection was not known in the majority of cases, our data do not exclude an association between peak levels of parvovirus B19 DNA and the development of complications. Maternal sera and corresponding fetal material were available for concurrent testing from 15 DNA-positive cases: in most fetal samples, viral DNA concentrations were several orders of magnitude higher (up to 2.1 x 10(12) copies/ml) compared to the corresponding maternal blood samples.

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“…In most healthy individuals it gives rise to a mild and self limiting illness [6,7]. In some groups such as people with certain malignancies, chronic haematological disease or immunodeficiency, severe disease can occur [8][9][10][11][12][13][14]. Infection with B19 during pregnancy has been associated with hydrops fetalis and fetal desth [15,16].…”

Section: Introductionmentioning

confidence: 99%

Parvovirus B19 outbreak on an adult ward

Seng¹,

Watkins

Morse³

et al. 1994

Epidemiol. Infect.

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SUMMARYIn November and December 1992, an outbreak of parvovirus B19 infection occurred among patients and staff on an adult mixed surgical ward at a large hospital in London. Three patients and 15 staff members were serologically confirmed as acute cases. The attack rate among susceptible members of staff was 47 %. In those infected, arthralgia (80 %) and rash (67 %) were the most common symptoms. Of six susceptible in-patients on the ward, three became infected. One of the in-patients who had carcinoma of the mouth was viraemic for more than 10 days with marrow suppression resulting in the postponement of chemotherapy until intravenous immunoglobulin was given and he was no longer viraemic. Control measures taken included closure of the ward to new admissions, transfer of only immune staff to the ward, and restriction of the ward nursing staff to working only on that ward. Although no specific exposure was conclusively identified as a risk factor, there was a suggestion of an increased risk of acquiring parvovirus B19 infection among those staff who did not adopt strict hand washing procedures after each physical contact with a patient (RR = 2-33; P = 0-07). Knowledge of parvovirus B19 among interviewed health care workers was poor: only 42 % reported knowing about parvovirus B19 and only 38% could name a patient category at risk of a severe outcome following infection. This is the first report of a nosocomial outbreak affecting an adult ward and of possible transmission of parvovirus B19 infection from staff to in-patients. Hospital control of infection teams should include parvovirus B19 in their outbreak containment plans.

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Human Parvovirus-Associated Red Cell Aplasia in the Absence of Underlying Hemolytic Anemia

Cited by 91 publications

References 0 publications

Severe Anemia Caused by Human Parvovirus in a Leukemia Patient on Maintenance Chemotherapy

Severe Anemia Caused by Human Parvovirus in a Leukemia Patient on Maintenance Chemotherapy

Parvovirus B19 infection in pregnancy: Quantitative viral DNA analysis using a kinetic fluorescence detection system (TaqMan PCR)

Parvovirus B19 outbreak on an adult ward

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