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Tabassum N, Bhuller K, Webster A, Siddiqui F, Dunkerton S, Khare M, Eamonn B, Mousa HA, Scudamore I, Roland D, Rowlands R, Bandi S, Rai VR, Bagul A, Jesus-Silva J, Bird PW, Young SR, James L, Toovey OTR, Tang JW. Clinical impact of recent surge in acute parvovirus B19 infections in Leicester UK, March-July 2024. J Med Virol 2024; 96:e29903. [PMID: 39223937 DOI: 10.1002/jmv.29903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Revised: 08/20/2024] [Accepted: 08/24/2024] [Indexed: 09/04/2024]
Affiliation(s)
- Nabila Tabassum
- Department of Paediatric Haematology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Kaljit Bhuller
- Department of Paediatric Haematology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Amy Webster
- Department of Adult Haematology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Farah Siddiqui
- Department of Fetal Medicine Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Suzanna Dunkerton
- Department of Fetal Medicine Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Manjiri Khare
- Department of Fetal Medicine Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Breslin Eamonn
- Department of Fetal Medicine Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Hatem A Mousa
- Department of Fetal Medicine Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Ian Scudamore
- Department of Fetal Medicine Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Damian Roland
- Department of Paediatric Emergency, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Rachel Rowlands
- Department of Paediatric Emergency, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Srini Bandi
- Department of Paediatrics, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Vinayak R Rai
- Department of Paediatrics, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Atul Bagul
- Department of Nephrology and Transplant, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Jorge Jesus-Silva
- Department of Nephrology and Transplant, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Paul W Bird
- Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Sarah R Young
- Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Lucy James
- Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Oliver T R Toovey
- Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Julian W Tang
- Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
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Zhang X, Wang J, Huang X, Zhu Y, Zhu Y, Tang L, Cai H, Fang X, Huang L. Case Report: Parvovirus B19 infection complicated by hemophagocytic lymphohistiocytosis in a heart-lung transplant patient. Front Immunol 2023; 14:1099468. [PMID: 36825017 PMCID: PMC9941661 DOI: 10.3389/fimmu.2023.1099468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/26/2023] [Indexed: 02/10/2023] Open
Abstract
Immunosuppressed patients can contract parvovirus B19, and some may experience hemophagocytic lymphohistiocytosis (HLH). Herein, we describe the first report of hemophagocytic lymphohistiocytosis in a heart-lung transplant patient with concomitant parvovirus B19 infection. The patient was treated with intravenous immune globulin (IVIG) and the features of HLH were remission. This instance emphasizes the significance of parvovirus B19 monitoring in transplant patients with anemia; if HLH complicates the situation, IVIG may be an adequate remedy. Finally, a summary of the development in diagnosing and managing parvovirus B19 infection complicated by HLH is provided.
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Affiliation(s)
- Xuewu Zhang
- Department of Critical Care Units, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Zhejiang Provincial Key Laboratory of Hematopoietic Malignancy, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jingxia Wang
- Department of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiaohan Huang
- Department of Nephrology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yue Zhu
- Department of Critical Care Units, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yijing Zhu
- Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Lingling Tang
- Department of Infectious Diseases, Shulan (Hangzhou) Hospital, Zhejiang Shuren University of Shulan International Medical College, Hangzhou, China
| | - Hongliu Cai
- Department of Critical Care Units, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Clinical Evaluation Technology for Medical Devices of Zhejiang Province, Hangzhou, China
| | - Xueling Fang
- Department of Critical Care Units, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingtong Huang
- Department of Critical Care Units, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Buus-Gehrig C, Bochennek K, Hennies MT, Klingebiel T, Groll AH, Lehrnbecher T. Systemic viral infection in children receiving chemotherapy for acute leukemia. Pediatr Blood Cancer 2020; 67:e28673. [PMID: 32918533 DOI: 10.1002/pbc.28673] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/25/2020] [Accepted: 08/10/2020] [Indexed: 12/14/2022]
Abstract
Systemic viral diseases frequently occur in allogeneic hematopoietic stem cell transplantation, but data in children receiving chemotherapy for acute leukemia are scarce. We therefore collected and analyzed the published data on symptomatic infection from cytomegalovirus, herpes simplex virus, varicella zoster virus, parvovirus B19, or adenovirus in pediatric acute leukemia. Reports on 68 children were identified, of whom 16 patients have died from the infection. Further studies have to (1) evaluate the true incidence of these infections in pediatric acute leukemia, (2) their impact on outcome, and (3) whether a subpopulation of patients could benefit from screening and prophylactic strategies.
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Affiliation(s)
- Constanze Buus-Gehrig
- Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Konrad Bochennek
- Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Marc T Hennies
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Thomas Klingebiel
- Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Andreas H Groll
- Infectious Disease Research Program, Center for Bone Marrow Transplantation and Department of Pediatric Hematology/Oncology, University Children's Hospital Münster, Münster, Germany
| | - Thomas Lehrnbecher
- Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, Johann Wolfgang Goethe-University, Frankfurt, Germany
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Tharwat Abou El-Khier N, Darwish A, El Sayed Zaki M. Molecular Study of Parvovirus B19 Infection in Children with
Acute Myeloid Leukemia. Asian Pac J Cancer Prev 2018; 19:337-342. [PMID: 29479965 PMCID: PMC5980917 DOI: 10.22034/apjcp.2018.19.2.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Parvovirus B19 is a common viral infection in children. Nearby evidences are present about its association with acute leukemia, especially acute lymphoblast leukemia. Nevertheless, scanty reports have discussed any role in acute myeloid leukemia (AML). Purpose: To evaluate the frequency of virological markers of B19 infection including its DNA along with specific immunoglobulins G (IgG) and M (IgM) among children with newly diagnosed AML. Besides, describing the clinical importance of Parvovirus B19 infection in those patients. Patients and methods: A case-control retrospective study was conducted on 48 children recently diagnosed with AML before and during chemotherapy induction and 60 healthy control. Specific serum IgM and IgG levels were determined by enzyme linked immunosorbant assay (ELISA) and DNA detection by polymerase chain reaction (PCR). Results: Parvovirus DNA was detected in 20 patients with AML. IgM was found in sera of four patients and one case had positive DNA and IgG (5%). Patients with recent parvovirus B19 infection had a significantly reduced hemoglobin levels, RBCs counts, platelet counts, neutrophil counts and absolute lymphocytosis (p=0.01, p=0.0001, p=0.01, p=0.02, p=0.0003, respectively). There were no clinical findings with statistically significant association to recent infection. Half of the patients with AML had positive PCR and/or IgM for parvovirus B19. Among children with AML under chemotherapy, there were reduced hemoglobin levels (P=0.03), reduced platelet counts (P=0.0001) and absolute neutropenia (mean±SD, 1.200 ±1.00) in those with parvovirus B19 infection. More than half of patients with parvovirus B19 (72.2%) had positive PCR and/or IgM and 36.4% of them had positive IgG. Conclusion: This study highlights that parvovirus B19 is common in children with AML either at diagnosis or under chemotherapy. There are no clinical manifestations that can be used as markers for its presence, but hematological laboratory findings can provide evidence for infection in the presence of anemia and neutropenia. Detection of parvovirus B19 by combined molecular and serological markers is required in such patients for accurate diagnosis.
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Abstract
ABSTRACT
Primary parvovirus B19 infection is an infrequent, but serious and treatable, cause of chronic anemia in immunocompromised hosts. Many compromised hosts have preexisting antibody to B19 and are not at risk. However, upon primary infection, some patients may be able to mount a sufficient immune response to terminate active parvovirus B19 infection of erythroid precursors. The most common consequence of B19 infection in the compromised host is pure red-cell aplasia, resulting in chronic or recurrent anemia with reticulocytopenia. Anemia persists until neutralizing antibody is either produced by the host or passively administered. Parvovirus B19 should be suspected in compromised hosts with unexplained or severe anemia and reticulocytopenia, or when bone-marrow examination shows either giant pronormoblasts or absence of red-cell precursors. Diagnosis is established by detection of B19 DNA in serum in the absence of IgG antibody to B19. In some cases, IgG antibody is detected but is not neutralizing. Anti-B19 IgM may or may not be present. Therapy includes any or all of the following: red-cell transfusion, adjustment in medications to restore or improve the patient’s immune system, and administration of intravenous immunoglobulin (IVIG). Following treatment, patients should be closely monitored, especially if immunosuppression is unchanged or increased. Should hematocrit trend downward and parvovirus DNA trend upward, the therapeutic options above should be revisited. In a few instances, monthly maintenance IVIG may be indicated. Caregivers should be aware that B19 variants, though rarely encountered, can be missed or under-quantitated by some real-time polymerase-chain reaction methods.
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Katragadda L, Shahid Z, Restrepo A, Muzaffar J, Alapat D, Anaissie E. Preemptive intravenous immunoglobulin allows safe and timely administration of antineoplastic therapies in patients with multiple myeloma and parvovirus B19 disease. Transpl Infect Dis 2013; 15:354-60. [DOI: 10.1111/tid.12067] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 10/18/2012] [Accepted: 10/29/2012] [Indexed: 11/30/2022]
Affiliation(s)
- L. Katragadda
- The Myeloma Institute; University of Arkansas for Medical Sciences; Little Rock; Arkansas; USA
| | - Z. Shahid
- The Myeloma Institute; University of Arkansas for Medical Sciences; Little Rock; Arkansas; USA
| | - A. Restrepo
- The Myeloma Institute; University of Arkansas for Medical Sciences; Little Rock; Arkansas; USA
| | - J. Muzaffar
- The Myeloma Institute; University of Arkansas for Medical Sciences; Little Rock; Arkansas; USA
| | - D. Alapat
- Department of Pathology; University of Arkansas for Medical Sciences; Little Rock; Arkansas; USA
| | - E. Anaissie
- Division of Hematology and Oncology; University of Cincinnati; Cincinnati; Ohio; USA
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7
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Stiehm ER, Keller MA. Passive immunization. Vaccines (Basel) 2013. [DOI: 10.1016/b978-1-4557-0090-5.00001-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Gosset C, Viglietti D, Hue K, Antoine C, Glotz D, Pillebout E. How many times can parvovirus B19-related anemia recur in solid organ transplant recipients? Transpl Infect Dis 2012; 14:E64-70. [DOI: 10.1111/j.1399-3062.2012.00773.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 03/07/2012] [Accepted: 03/13/2012] [Indexed: 12/22/2022]
Affiliation(s)
- C. Gosset
- Néphrologie-Transplantation; Hôpital Saint-Louis; Université Paris VII; Paris; France
| | - D. Viglietti
- Néphrologie-Transplantation; Hôpital Saint-Louis; Université Paris VII; Paris; France
| | - K. Hue
- Néphrologie; CHU Pointe-à-Pitre; Guadeloupe; France
| | - C. Antoine
- Néphrologie-Transplantation; Hôpital Saint-Louis; Université Paris VII; Paris; France
| | - D. Glotz
- Néphrologie-Transplantation; Hôpital Saint-Louis; Université Paris VII; Paris; France
| | - E. Pillebout
- Néphrologie-Transplantation; Hôpital Saint-Louis; Université Paris VII; Paris; France
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Grabarczyk P, Kalińska A, Kara M, Wieczorek R, Ejduk A, Sulkowska E, Gołębiowska-Staroszczyk S, Matysiak M, Baylis SA, Brojer E. Identification and characterization of acute infection with parvovirus B19 genotype 2 in immunocompromised patients in Poland. J Med Virol 2010; 83:142-9. [DOI: 10.1002/jmv.21947] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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10
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Kivity S, Katz U, Daniel N, Nussinovitch U, Papageorgiou N, Shoenfeld Y. Evidence for the use of intravenous immunoglobulins--a review of the literature. Clin Rev Allergy Immunol 2010; 38:201-69. [PMID: 19590986 PMCID: PMC7101816 DOI: 10.1007/s12016-009-8155-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Intravenous immunoglobulins (IVIg) were first introduced in the middle of the twentieth century for the treatment of primary immunodeficiencies. In 1981, Paul Imbach noticed an improvement of immune-mediated thrombocytopenia, in patients receiving IVIg for immunodeficiencies. This opened a new era for the treatment of autoimmune conditions with IVIg. Since then, IVIg has become an important treatment option in a wide spectrum of diseases, including autoimmune and acute inflammatory conditions, most of them off-label (not included in the US Food and Drug Administration recommendation). A panel of immunologists and internists with experience in IVIg therapy reviewed the medical literature for published data concerning treatment with IVIg. The quality of evidence was assessed, and a summary of the available relevant literature in each disease was given. To our knowledge, this is the first all-inclusive comprehensive review, developed to assist the clinician when considering the use of IVIg in autoimmune diseases, immune deficiencies, and other conditions.
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Affiliation(s)
- Shaye Kivity
- Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
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Cao YH, Zhang GY, Zhang GC. Successful treatment with high-dose intravenous immunoglobulin for parvovirus b19 infection associated with acute fulminant hepatitis in a chinese child. Clin Pediatr (Phila) 2009; 48:674-6. [PMID: 19286620 DOI: 10.1177/0009922809332686] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yu-Hong Cao
- Department of Pediatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Bhattacharya S, Paneesha S, Chaganti S, Lovell R, Slocombe G, Milligan D, Osman H. "Viral" myocarditis in a patient following allogenic stem cell transplant: diagnostic dilemma and management considerations. J Clin Virol 2009; 45:262-4. [PMID: 19501546 DOI: 10.1016/j.jcv.2009.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 04/30/2009] [Accepted: 05/01/2009] [Indexed: 10/20/2022]
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