Presence of perineuritis in a case of papular purpuric gloves and socks syndrome associated with mononeuritis multiplex attributable to B19 parvovirus

Aguilar-Bernier, M.; Bassas-Vila, J.; Torné-Gutiérrez, José Ignacio; Martínez-García, Gerardo; Aragoneses-Fraile, Henar; Miranda‐Romero, A.

doi:10.1016/j.jaad.2005.10.012

Cited by 21 publications

(15 citation statements)

References 18 publications

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“…Aguilar-Bernier et al [1] recently described the coexistence of a neuropathy with cutaneous lesions but in the form of a gloves and socks syndrome associated with B19V. Gloves and socks syndrome is a typical exanthema limited to the hands and feet that may be caused by B19V, with dysesthesia and/or paresthesia in the areas affected by exanthema being regularly observed.…”

Section: Discussionmentioning

confidence: 99%

“…The occurrence of authentic mononeuritis multiplex (MM) has rarely been described in the context of B19V-associated polyarteritis nodosa and papular purpuric gloves and socks syndrome [1,3,15]. We report here three cases of MM unambiguously associated with B19V infection in the absence of systemic features or restricted to a limited cutaneous eruption.…”

Section: Introductionmentioning

confidence: 93%

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Mononeuropathy multiplex associated with acute parvovirus B19 infection: characteristics, treatment and outcome

Lenglet¹,

Haroche

Schnuriger

et al. 2011

J Neurol

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To describe the characteristics of peripheral neuropathy related to acute parvovirus B19 (B19V) infection. We reviewed clinical, electrophysiological and histological data of three patients with peripheral neuropathy and positive B19V detection (IgG, IgM and PCR) compatible with acute infection. The neuropathy fulfilled criteria for mononeuropathy multiplex (MM). It could be preceded by or concurrent with a limited purpuric eruption, but systemic manifestations were absent. The first neurological symptoms were always sensory and localized in a hand. Neuropathy was initially limited to a restricted sensory part of a nerve trunk territory. The course was subacute with successive and asymmetric injury of the limb and cranial nerves. Electromyographic study confirmed the diagnosis of MM with multifocal asymmetric sensory and motor axonal loss in two patients, whereas the neuropathy was purely sensory and limited to two nerves in the other patient. Nerve biopsies showed no evidence of necrotizing vasculitis but, in one patient, revealed a lymphocytic perivascular infiltrate evocative of hypersensitivity vasculitis secondary to an infectious agent. Intravenous immunoglobulin (IVIg) was systematically administered. Long-term outcome was good but with incomplete sensory recovery and, for one patient, persistence of a functional disability. B19 V infection should be considered in the etiological assessment of MM, especially in the event of a progressive sensory disorder in the hands and a concomitant history of rash. IVIg may be an effective treatment for this inflammatory disorder.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

Mononeuropathy multiplex associated with acute parvovirus B19 infection: characteristics, treatment and outcome

Lenglet¹,

Haroche

Schnuriger

et al. 2011

J Neurol

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“…Cases were selected either randomly or by showing a purpuric perivascular dermatitis similar to cases reported in the literature for PPGSS. 12 Clinical diagnoses in these cases included eczema, lichen ruber, erythema multiforme, purpura, pityriasis lichenoides, pityriasis rosea, pyogenic granuloma, sarcoidosis, erythema nodosum, Sweet syndrome, subacute lupus, urticaria, and vasculitis, among others. Histopathologic patterns predominating were perivascular dermatitis with or without a purpuric component (54 cases), lichenoid dermatitis (11 cases), and vasculitis (8 cases), the remaining representing examples of granulomatous or diffuse dermatitis.…”

Section: Methodsmentioning

confidence: 99%

Immunohistochemical Detection of Parvovirus B19 in “Gloves and Socks” Papular Purpuric Syndrome: Direct Evidence for Viral Endothelial Involvement. Report of Three Cases and Review of the Literature

Santonja

Nieto-González²,

Santos‐Briz³

et al. 2011

The American Journal of Dermatopathology

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Papular-purpuric "gloves and socks" syndrome is a distinctive dermatosis featuring acral pruritus, edema, and petechiae. It has been attributed in most--but not all--reported cases to Parvovirus B19 infection, on the grounds of serological proof of recent infection or detection of viral DNA by polymerase chain reaction in patient serum or biopsies. We report the immunohistochemical detection of Parvovirus B19 VP2 structural protein in the endothelial lining of dermal blood vessels in 3 examples of Papular-purpuric "gloves and socks" syndrome and review previously described immunohistochemical investigations in cutaneous involvement by this infection.

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“…Other neurologic manifestations associated with PVB19 infection occurred only in immunocompetent patients and included acute cerebellar ataxia with nystagmus in a child, which occurred concurrently with a rash and resolved within a week [34]; Guillain-Barré syndrome involving the legs, with onset 5 days after the diagnosis of erythema infectiosum, in a child who experienced gradual improvement [35]; peripheral facial nerve paralysis in a child with a mononucleosis-like syndrome and parotitis who developed a rash 6 days later and improved after 6 weeks [43]; velopalatine hemiparalysis that manifested 1 week after diarrhea and lasted for 10 weeks [44]; and dysesthesias or paresthesias of the hands, legs, and face that lasted up to 8 months [45,46,62].…”

Section: Epidemiologymentioning

confidence: 99%

Neurologic Manifestations Associated with Parvovirus B19 Infection

2009

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Eighty-one cases of neurologic disease, including encephalitis, meningitis, stroke, and peripheral neuropathy, that were associated with parvovirus B19 infection were reviewed. Most patients were children, and two-thirds had central nervous system manifestations. One-third had altered immunity. Viral symptoms (odds ratio [OR], 5.7; P= .002), rash (OR, 11.5; P< .001), and peripheral nervous system involvement (OR, 12.1; P= .004) were more frequent in immunocompetent patients. Brain magnetic resonance imaging abnormalities were more frequent in patients with altered immunity (OR, 10; P= .04). In central nervous system disease, parvovirus B19 DNA was commonly detected in cerebrospinal fluid (81% of samples) and serum (85%), whereas specific antibodies were found in 33% of cerebrospinal fluid samples. Neurologic sequelae occurred in 22% of 77 patients with a known outcome, and some improvement occurred in 16%. No differences in the prevalence of sequealae were noted between immunocompetent patients (21% of whom experienced sequealae) and patients with altered immunity (25%) or between patients with central nervous system manifestations who received intravenous immunoglobulin with or without steroids and those patients with central nervous system manifestations who did not. Five patients died.

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Presence of perineuritis in a case of papular purpuric gloves and socks syndrome associated with mononeuritis multiplex attributable to B19 parvovirus

Cited by 21 publications

References 18 publications

Mononeuropathy multiplex associated with acute parvovirus B19 infection: characteristics, treatment and outcome

Mononeuropathy multiplex associated with acute parvovirus B19 infection: characteristics, treatment and outcome

Immunohistochemical Detection of Parvovirus B19 in “Gloves and Socks” Papular Purpuric Syndrome: Direct Evidence for Viral Endothelial Involvement. Report of Three Cases and Review of the Literature

Neurologic Manifestations Associated with Parvovirus B19 Infection

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