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Wei D, Jensen H, Dwyre DM. Intrauterine parvovirus B19 infection. Transfusion 2018; 58:1095-1096. [PMID: 29683514 DOI: 10.1111/trf.14595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 11/03/2017] [Accepted: 11/13/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Dongguang Wei
- Department of Pathology and Laboratory Medicine, University of California, Davis Health System, Davis, California
| | - Hanne Jensen
- Department of Pathology and Laboratory Medicine, University of California, Davis Health System, Davis, California
| | - Denis M Dwyre
- Department of Pathology and Laboratory Medicine, University of California, Davis Health System, Davis, California
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Hematologic Manifestations of Childhood Illness. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00152-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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3
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Unexplained chronic leukopenia treated with oral iron supplements. Int J Clin Pharm 2013; 36:264-7. [PMID: 24346817 PMCID: PMC7101904 DOI: 10.1007/s11096-013-9897-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 11/25/2013] [Indexed: 11/29/2022]
Abstract
Case A 67-year-old woman known to have iron deficiency anemia and persistent unexplained chronic leukopenia was cared for by our medical center for about 16 years. During this period she was examined thoroughly and diagnosed to have chronic idiopathic neutropenia (also known as chronic benign neutropenia). Her iron deficiency was attributed to nutritional factors and she was non-compliant with her oral iron supplements. The patient fully received her iron supplement medication by nursing staff for two and a half months during an unexpected prolonged hospital stay after her suffering an acute ischemic cerebrovascular accident. An astonishing outcome was that in addition to having her iron deficiency anemia treated, her long-term unexplained neutropenia was also corrected. Conclusion Some patients diagnosed with chronic idiopathic neutropenia and clinically present as having unexplained chronic neutropenia might actually be suffering from a form of not yet described iron deficiency induced neutropenia.
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Parvovirus b19 associated hepatitis. HEPATITIS RESEARCH AND TREATMENT 2013; 2013:472027. [PMID: 24232179 PMCID: PMC3819764 DOI: 10.1155/2013/472027] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 08/10/2013] [Accepted: 09/04/2013] [Indexed: 12/21/2022]
Abstract
Parvovirus B19 infection can present with myriads of clinical diseases and syndromes; liver manifestations and hepatitis are examples of them. Parvovirus B19 hepatitis associated aplastic anemia and its coinfection with other hepatotropic viruses are relatively underrecognized, and there is sufficient evidence in the literature suggesting that B19 infections can cause a spectrum of liver diseases from elevation of transaminases to acute hepatitis to fulminant liver failure and even chronic hepatitis. It can also cause fatal macrophage activation syndrome and fibrosing cholestatic hepatitis. Parvovirus B19 is an erythrovirus that can only be replicate in pronormoblasts and hepatocytes, and other cells which have globosides and glycosphingolipids in their membrane can also be affected by direct virus injury due to nonstructural protein 1 persistence and indirectly by immune mediated injury. The virus infection is suspected in bone marrow aspiration in cases with sudden drop of hemoglobin and onset of transient aplastic anemia in immunosuppressed or immunocompetent patients and is confirmed either by IgM and IgG positive serology, PCR analysis, and in situ hybridization in biopsy specimens or by application of both. There is no specific treatment for parvovirus B19 related liver diseases, but triple therapy regimen may be effective consisting of immunoglobulin, dehydrohydrocortisone, and cyclosporine.
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Abstract
Infection with parvovirus B19 causes several clinical syndromes (fifth disease, transient aplastic crisis, pure red cell aplasia, and hydrops fetalis) and may contribute to other illnesses. B19 has been linked to renal disease in three settings: As a cause of acute glomerulopathy and as a cause of anemia in ESRD and kidney transplantation. Case reports implicate parvovirus in the pathogenesis of proliferative glomerulonephritis and collapsing glomerulopathy, but a causal relationship has not been established. A proposed role for B19 infection is based on the temporal association of renal findings with viral infection, positive serology, and identification of the viral genome in the glomerulus. Mechanisms may include cytopathic effects on glomerular epithelial cells and/or endothelial cells and glomerular deposition of immune complexes. Patients who require dialysis may have increased susceptibility to acute and chronic anemia after parvoviral infection. Factors that predispose this population to complications of B19 infection include impaired immune response, deficient erythropoietin production, and possibly decreased erythrocyte survival. The clinical burden of parvovirus B19 infection in renal transplant recipients may be underestimated; these individuals may develop persistent viremia as a result of a dysfunctional immune response. Chronic anemia and pure red blood cell aplasia are the most common complications of parvovirus infection in this population; the diagnosis should be considered in transplant recipients with unexplained anemia or pancytopenia. Allograft rejection and dysfunction have been reported in association with infection, but a cause-effect relationship has not been proved. Further investigation of the relationship between B19 and kidney disease is warranted.
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Affiliation(s)
- Meryl Waldman
- Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892-1268, USA. merylw@.niddk.nih.gov
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McNeely M, Friedman J, Pope E. Generalized petechial eruption induced by parvovirus B19 infection. J Am Acad Dermatol 2005; 52:S109-13. [PMID: 15858505 DOI: 10.1016/j.jaad.2004.11.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Parvovirus infection classically causes erythema infectiosum. During the past 2 decades, other unusual skin eruptions have been noted in association with parvovirus infection. Papular purpuric gloves and socks syndrome is one form of parvovirus infection described mostly in white, young adult patients. Recently, there have been reports of a few patients with acropetechial syndrome consisting of a papular purpuric gloves and socks syndrome-like presentation with additional involvement of the perioral and chin area, temporally associated with acute parvovirus B19 infection. We report a case of a 7-year-old boy with serologic evidence of acute parvovirus B19 infection who developed a generalized petechial eruption with lesions concentrated on his extremities and face. We also reviewed the literature and summarized the various cutaneous presentations of parvovirus infection.
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Affiliation(s)
- Mike McNeely
- The Hospital for Sick Children, Toronto, Ontario, Canada
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Tourneux P, Jouvencel P, Micheau M, Jouvencel AC, Chateil JF, Barba G, Letavernier B, Llanas B. [Parvovirus B19 thrombocytopenic purpura complicated with a cerebral hemorrhage]. Arch Pediatr 2005; 12:281-3. [PMID: 15734124 DOI: 10.1016/j.arcped.2004.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2003] [Accepted: 11/12/2004] [Indexed: 10/25/2022]
Abstract
UNLABELLED Severe hemorrhage complications are rare in idiopathic thrombocytopenic purpura. This pathology is often considered as benign. CASE REPORT We report the case of a four-year-old boy presenting a parvovirus B19 idiopathic thrombocytopenic purpura. Despite early and repeated use of intravenous immunoglobulin, the evolution was characterized by the secondary apparition of a cerebral hemorrhage. It was lethal seven days after the initial diagnosis. CONCLUSION Parvovirus B19 should be investigated as an etiologic agent of idiopathic thrombocytopenic purpura, using PCR. The unpredictive aspect of severe hemorrhage complications, especially cerebral hemorrhages, explains the potential severity of this disease.
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Affiliation(s)
- P Tourneux
- Service de médecine néonatale et réanimation pédiatrique polyvalente, CHU d'Amiens, hôpital Nord, 1, place Victor-Pauchet, 80054 Amiens cedex 1, France.
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Aktepe OC, Yetgin S, Olcay L, Ozbek N. Human parvovirus B19 associated with idiopathic thrombocytopenic purpura. Pediatr Hematol Oncol 2004; 21:421-6. [PMID: 15205085 DOI: 10.1080/08880010490457141] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Although human parvovirus B19 (PVB19) is mainly known to be the causative agent of fifth disease, it is also important in the etiopathogenesis of various hematologic disorders. Recently, its role in the occurrence of chronic anemia and pancytopenia in immunocompromised patients has been revealed. In this study, the authors searched for the presence of PVB19 in a group of patients with idiopathic thrombocytopenic purpura (ITP). The PVB19 DNA was determined by nested PCR, and serologic responses to the virus were evaluated by ELISA. Viral genome was detected by PCR in the sera of 9 of the 19 patients. The IgM and IgG positivities were 57 and 73% in the patients, respectively. These results suggest that PVB19 is associated with ITP nearly in half of the patients and its pathogenetic role in the cases of ITP needs further consideration.
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Affiliation(s)
- Orhan Cem Aktepe
- Hacettepe University, Faculty of Medicine, Department of Pediatrics, Section of Hematology, Ankara, Turkey; and Afyon Kocatepe University, Faculty of Medicine, Department of Microbiology, Afyon, Turkey
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Abstract
This review discusses disorders of altered neutrophil number and function and provide a basic framework for patient evaluation and management. The sections begin with neutropenia, neutrophilia and neutrophil dysfunction with a general screening approach to differentiate common, more benign syndromes from rare, often more serious disorders. Also included is a detailed discussion of some specific primary neutrophil syndromes at the end of each section. Focus is placed on specific disorders that are clinically common or particularly instructive.
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Affiliation(s)
- Wade Kyono
- Division of Pediatric Hematology-Oncology, University of Hawaii John A. Burns School of Medicine, Kapiolani Medical Center, Honolulu 96826, USA.
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Fisgin T, Yarali N, Duru F, Kara A. Parvovirus-B19 infection preceding acute myeloid leukemia with orbital granulocytic sarcoma. Leuk Lymphoma 2002; 43:2059-61. [PMID: 12481910 DOI: 10.1080/1042819021000016168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We report here an unusual presentation of acute nonlymphoblastic leukemia with ocular granulocytic sarcoma who was firstly diagnosed iron deficiency anemia and acute parvovirus infection induced erythroid hypoplasia. To our knowledge this is the first paper of acute myeloblastic leukemia (AML) with granulocytic sarcoma, preceded by acute Parvovirus B19 infection.
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MESH Headings
- Acute Disease
- Anemia, Iron-Deficiency/therapy
- Erythema Infectiosum/complications
- Humans
- Infant
- Leukemia, Myeloid/complications
- Leukemia, Myeloid/diagnosis
- Leukemia, Myeloid/drug therapy
- Leukemia, Myelomonocytic, Acute/complications
- Leukemia, Myelomonocytic, Acute/diagnosis
- Leukemia, Myelomonocytic, Acute/drug therapy
- Male
- Orbital Neoplasms/complications
- Orbital Neoplasms/drug therapy
- Parvovirus B19, Human
- Remission Induction
- Sarcoma, Myeloid/complications
- Sarcoma, Myeloid/drug therapy
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Affiliation(s)
- Tunc Fisgin
- Department of pediatric hematology, Dr Sami Ulus Children's Hospital, Telsizler-Ankara 06900, Turkey.
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Raza A. Consilience across evolving dysplasias affecting myeloid, cervical, esophageal, gastric and liver cells: common themes and emerging patterns. Leuk Res 2000; 24:63-72. [PMID: 10634648 DOI: 10.1016/s0145-2126(99)00152-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
In the present paper, an attempt is made to identify common biologic themes across dysplastic states affecting the marrow, gastro intestinal tissue, the cervix and liver as well as unifying patterns during disease evolution. The following algorithm appears generally applicable, although individual variations must necessarily be anticipated. It appears that there is an initial transforming event which in all dysplasias except that affecting the marrow has been found to be infectious. Increased cellular proliferation-increased apoptosis, telomere shortening, appearance of telomerase expression and clonal expansion follow the initial insult. Abnormalities in the cytokine environment are universally described and it is likely that the quintessential monoclonality aspect of dysplasia predisposes to accumulation of genetic mutations, and microsatellite instability leading to the appearance of evolved sub-clones. The conversion of a dysplastic phenotype to a malignant one reflects the success of one such sub-clone in developing a survival advantage over a large population of prematurely apoptotic neighbors. This state is usually acquired by silencing tumor suppressor genes through hypermethylation or actual loss or dysfunction. Thus, excessive apoptosis of cells resulting from a persistent infectious process predisposes the organ towards developing a cancerous phenotype. Evidence for the shared pathology is presented at length with the hope that these parallels between dysplastic states will be helpful in both biologic and therapeutic research.
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Affiliation(s)
- A Raza
- Pre-Leukemia and Leukemia Program, Rush Cancer Institute, Rush-Presbyterian, St. Luke's Medical Center, Chicago, IL 60612-3515, USA
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Bisognano JD, Morgan MB, Lowes BD, Wolfel EE, Lindenfeld J, Zisman LS. Acute parvovirus infection in a heart transplant recipient. Transplant Proc 1999; 31:2159-60. [PMID: 10456000 DOI: 10.1016/s0041-1345(99)00293-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J D Bisognano
- University of Colorado Health Sciences Center, Denver, USA
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Stéphan JL, Galambrun C, Pozzetto B, Grattard F, Bordigoni P. Aplastic anemia after Mycoplasma pneumoniae infection: a report of two cases. J Pediatr Hematol Oncol 1999; 21:299-302. [PMID: 10445893 DOI: 10.1097/00043426-199907000-00011] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Two very unusual cases of aplastic anemia complicating mycoplasma infection are described. Each patient had preexisting hematologic abnormalities at the time of the infection: reactive hemophagocytic syndrome in one, and autoimmune hemolytic anemia associated with cold autoantibodies in the other. This adds another entity to the protean manifestations of Mycoplasma pneumoniae infection.
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Affiliation(s)
- J L Stéphan
- Pediatric Hematology Unit, Saint-Etienne, France
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