Multiple small pulmonary emboli associated with transient antiphospholipid syndrome in human Parvovirus B19 infection

Abstract

Antiphospholipid antibodies (aPL) have been reported to occur in several conditions other than antiphospholipid syndrome, including infections. We herein report the case of a 21-year-old Japanese woman with Parvovirus B19 infection, who developed multiple pulmonary emboli associated with aPL, a lupus anticoagulant and IgM anticardiolipin antibody. Eight weeks later, antiphospholipid antibodies spontaneously disappeared and normal pulmonary flow was observed. Considering the high prevalence of Parvovirus B19 infection, we should be aware of thrombosis associated with transient aPL antibodies in this infectious disease.

Antiphospholipid antibodies in response to infection

“…To our knowledge, there have been at least two reports of thrombotic events associated with aPL and parvovirus B19 infection. A healthy young man with acute parvovirus B19 infection developed splenic infarction associated with the presence of IgM and IgG aCL [14], and a 21-year-old woman developed multiple pulmonary emboli in association with transient presence of LA and IgM aCL [15].…”

Pulmonary Thrombosis with Transient Antiphospholipid Syndrome after Mononucleosis-like Illness

“…Molecular mimicry has been proposed as the main mechanism for production of aPL in parvovirus B19 infection (4)(5)(6) (19). However, in only 4 of 21 reported cases, aPL were positive (7)(8)(9)(10)(11)(12)(13) (8,9,13).…”

“…One reason postulated is that most viral infections produce β2-GPI-independent aPL (1,6). β2-GPI is a single chain normal plasma protein that binds anionic phospholipids as a cofactor and is considered to be a regulator of coagulation.…”

Keeping it in the family: Three relatives with HbSC disease and simultaneous acute pulmonary emboli

“…The link between HPV B19 infection and a variety of auto‐immune disorders has been described. Two case series in non‐SCD patients describe the transient induction of antiphospholipid antibodies with resultant pulmonary emboli in the setting of acute HPV 19 infection [32, 33]. One case report describes parvovirus infection followed by thromboembolic stroke and transient antiphospholipid antibodies in a pediatric SCD patient [34].…”