Lack of evidence for a direct involvement of muscle infection by parvovirus B19 in the pathogenesis of inflammatory myopathies: a follow-up study

Chevrel, Guillaume; Borsotti, J. P.; Miossec, Pierre

doi:10.1093/rheumatology/keg085

Cited by 20 publications

(7 citation statements)

References 16 publications

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“…There are several case reports of parvovirus B19 infection causing myositis in adults, but, in one case series, muscle biopsies in patients with myositis and parvovirus infection did not reveal the presence of B19 DNA, suggesting that parvovirus is not directly responsible for causing the myositis [6, 27]. Nevertheless, there may be an indirect immunologic mechanism involved, as parvovirus infection has been thought to precipitate several autoimmune disorders, most famously rheumatoid arthritis and systemic lupus erythematosis.…”

Section: Discussionmentioning

confidence: 99%

Acquired factor VIII deficiency: two case reports and a review of literature

Bao

2017

Exp Hematol Oncol

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BackgroundAcquired factor VIII (FVIII) deficiency, or acquired hemophilia A (AHA), is a rare autoimmune disorder involving antibody-mediated depletion of coagulation FVIII, leading to severe, life-threatening bleeding. The condition is often associated with other autoimmune disorders, and its treatment involves replacement of FVIII and various modes of immunosuppression. Recently, a few noteworthy therapeutic advances have been made. We present two cases of severe AHA in Chinese women. One of these women developed this disorder in the setting of possible parvovirus B19 infection, which has not yet been reported in association with AHA. Other notable features of her case included paradoxical venous thrombosis and possible association with Sjogren’s syndrome and myositis. The other woman failed to respond to usual first-line therapies despite exhibiting a less severe clinical course, illustrating the varied but potentially stubborn behavior of this disorder.Case 1An 87-year-old woman presented with diffuse ecchymoses, melena, vaginal bleeding. Labs showed hemoglobin (Hgb) nadir of 5.7 mg/dL, elevated partial thromboplastin time (PTT), FVIII level <1%, mixing study consistent with an inhibitor, elevated anti-Sjogren’s-Syndrome-related antigen A antibody, elevated creatinine kinase, and elevated parvovirus IgM and IgG. Imaging of her arm showed diffuse myositis and deep venous thrombosis. After intravenous and oral steroids, her FVIII levels normalized, and her symptoms subsided.Case 2A 59-year-old woman presented with recurrent ecchymoses and hematomas in her extremities. Labs showed Hgb of 11.7 mg/dL, elevated PTT, FVIII level of 3%, and mixing study consistent with an inhibitor. Despite receiving a long course of steroids, several courses of IVIG, and a few courses of Rituximab, her FVIII level remained critically low.ConclusionThe rarity of AHA limits our understanding of this disease and the ability to perform trials to discover optimal therapies. We hope that these case reports and discussion will shed further light on the varied clinical manifestations and natural histories of this disorder to guide better recognition and treatment of AHA.

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Section: Discussionmentioning

confidence: 99%

Acquired factor VIII deficiency: two case reports and a review of literature

Bao

2017

Exp Hematol Oncol

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“…Embora a maioria dos pacientes com miopatias inflamatórias apresente aumento dos níveis de creatina fosfoquinase, as séries publicadas incluem alguns pacientes com níveis normais de CPK. [9][10][11] Nesses casos, embora a miopatia fosse diagnosticada por métodos como biópsia e RM, os níveis de CPK estavam normais. Não foram apresentadas evidências concretas que explicassem essa situação.…”

Section: Discussionunclassified

Infecção por parvovírus B19 como causa de miosite aguda em um adulto

Çakırca

Karatoprak

Uğurlu³

et al. 2015

Revista Brasileira de Reumatologia

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Parvovirus B19 infection is often asymptomatic, but clinical expressions may include transient aplastic crisis, erythema infectiosum, non-immune hydrops fetalis, and chronic red cell aplasia. This virus has also been associated with rheumatoid arthritis and other autoimmune connective tissue diseases; however, we could not identify any acute adult myositis case developed after a Parvovirus B19 infection in the literature. For this reason, we would like to present a rare case of acute myositis developed after Parvovirus B19 infection. In patients presenting with symptoms of fever, rash on the legs and myositis, viral infections such as Parvovirus B19 should be kept in mind.

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“…In most cases of IIM, on-going infection cannot be identified [8]. In a few cases of IIM, as recently published for the Parvovirus B19, the presence of the virus in muscle does not seem to be the trigger of inflammation [9,10]. If an infectious agent does contribute to the pathogenic process leading to myositis, it is probably through indirect mechanisms in patients with particular genetic or other risk factors.…”

Section: Antigensmentioning

confidence: 94%

Novel aspects on the contribution of T cells and dendritic cells in the pathogenesis of myositis

2006

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This review focuses on recent advances and new hypothesis in the understanding of the T and dendritic cells contribution to the pathogenesis of idiopathic inflammatory myopathies (IIMs), especially polymyositis (PM) and dermatomyositis (DM). The new data show that non-specific amplification of muscle inflammation by T lymphocyte and dendritic cells may result from the local production of cytokines and chemokines. Synergistic interactions between these factors explain some of the clinical features. The potent role of these molecules suggests their potential for therapeutic manipulation using specific inhibitors.

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Lack of evidence for a direct involvement of muscle infection by parvovirus B19 in the pathogenesis of inflammatory myopathies: a follow-up study

Abstract: Our results do not support the direct implication of parvovirus B19 in the pathogenesis of myositis.

Cited by 20 publications

References 16 publications

Acquired factor VIII deficiency: two case reports and a review of literature

Acquired factor VIII deficiency: two case reports and a review of literature

Infecção por parvovírus B19 como causa de miosite aguda em um adulto

Novel aspects on the contribution of T cells and dendritic cells in the pathogenesis of myositis

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