Parvovirus B19 infection mimicking systemic lupus erythematosus, successfully treated with intravenous immune globulin

Abstract

Introduction Parvovirus B19 infection generally presents as a transient viral illness in children but rarely shows systemic lupus erythematosus-like symptoms.Case report Here we present a 7-year-old girl with parvovirus B19 infection who had prolonged fever, rash, pancytopenia and hypocomplementemia making it difficult do differentiate from the first episode of systemic lupus erythematosus. Because she had severe progressive pancytopenia she was administered intravenous immune globulin treatment and her clinical course was dramatically improved.Discussion Parvovirus B19 infection can mimic systemic lupus erythematosus and it may be difficult to differentiate a recent parvovirus B19 infection and the first presentation of systemic lupus erythematosus. Absence of discoid lesions, alopecia, Raynaud phenomenon and autoimmune hemolytic anemia may help to distinguish parvovirus B19 infection from systemic lupus erythematosus.Conclusions Parvovirus B19 infection may cause a severe clinical picture resembling systemic lupus erythematosus even in otherwise healthy children. Intravenous immune globulin treatment might be considered in cases resistant to supportive management.

Detection of Human Parvovirus B19 Infection in Cases of Systemic Lupus Erythematosus Attending Benha University Hospitals

“…Several studies and case reports have implicated PV-B19 in inducing flares of SLE and that treatment for B19 in SLE patients with this infection might be useful to reduce flare-ups of such a serious disease, and administration of immunoglobulins could be helpful to control infection if discontinuation of the immunosuppressive therapy is not feasible 10 .…”

“…PV-B19 has the potential to induce transient autoimmune response manifesting as lupus-like symptoms such as malar rash, fever, arthropathy, myalgia, cytopenia, pleuritis, myopericarditis and acute hepatitis 9 . The family history, a self-limiting disease course , absence of discoid lesions, alopecia, Raynaud phenomenon and autoimmune hemolytic anemia and presence of short-lived, low levels of antibodies (particularly ANA& anti-dsDNA) may help in diagnosis of PV-B19 infection but a laboratory diagnosis is required for accurate diagnosis of PV-B19 infection 10 .…”