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. 2018 Jul 4;18(1):302.
doi: 10.1186/s12879-018-3227-1.

Extra-haematological manifestations related to human parvovirus B19 infection: retrospective study in 25 adults

Marion Dollat  1 , Benjamin Chaigne  1 , Grégoire Cormier  2 , Nathalie Costedoat-Chalumeau  1 , François Lifermann  3 , Alban Deroux  4 , Emilie Berthoux  5 , Emmanuelle Dernis  6 , Thomas Sené  7 , Gilles Blaison  8 , Olivier Lambotte  9 , Benjamin Terrier  1 , Jérémie Sellam  10 , Luc De Saint-Martin  11 , Laurent Chiche  12 , Nicolas Dupin  13 , Luc Mouthon  14   15
Affiliations

Extra-haematological manifestations related to human parvovirus B19 infection: retrospective study in 25 adults

Marion Dollat et al. BMC Infect Dis. .

Abstract

Background: To describe extra-haematological manifestations associated with human parvovirus B19 (HPV-B19) infection.

Methods: We conducted a nationwide multicentre study to retrospectively describe the characteristics and outcome of extra-haematological manifestations in French adults.

Results: Data from 25 patients followed from 2001 to 2016 were analysed. Median age was 37.9 years (range: 22.7-83.4), with a female predominance (sex ratio: 4/1). Only 3 patients had an underlying predisposing condition (hemoglobinopathy or pregnancy). The most common manifestations were joint (80%) and skin (60%) involvement. Four patients (16%) had renal involvement (endocapillary proliferative or membranoproliferative glomerulonephritis, focal segmental glomerulosclerosis). Three patients (12%) had peripheral nervous system involvement (mononeuritis, mononeuritis multiplex, Guillain-Barré syndrome) and 2 (8%) presented muscle involvement. Other manifestations included hemophagocytic lymphohistiocytosis (n = 1), myopericarditis and pleural effusion (n = 1), and lymphadenopathy and splenomegaly mimicking lymphoma with spleen infarcts (n = 1). Immunological abnormalities were frequent (56.5%). At 6 months, all patients were alive, and 54.2% were in complete remission. In 2 patients, joint involvement evolved into rheumatoid arthritis. Six patients (24%) received intravenous immunoglobulin (IVIg), with a good response in the 3 patients with peripheral nervous system involvement.

Conclusions: HPV-B19 infection should be considered in a wide range of clinical manifestations. Although the prognosis is good, IVIg therapy should be discussed in patients with peripheral nerve involvement. However, its efficacy should be further investigated in prospective studies.

Keywords: Arthritis; Glomerulonephritis; Human parvovirus B19; Intravenous immunoglobulin, lupus; Peripheral neuropathy; Vasculitis.

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Conflict of interest statement

Ethics approval and consent to participate

This study was conducted in compliance with the protocol of Good Clinical Practices and Declaration of Helsinki principles. In accordance with French law (Loi de Santé publique 2004 - Loi n° 2004–806 du 9 août 2004), the need for consent was deemed unnecessary and formal approval from an ethical committee was not required for this study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Skin manifestations related to human parvovirus B19 infection. Panel a: periflexural purpuric exanthema. Panel b: purpuric lesions of the lower limbs in a patient with the gloves and socks pattern. Pnael c: reticulate and annular exanthema of the trunk
See this image and copyright information in PMC

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