Serological and molecular evaluation of parvovirus B19 (B19V) in blood donors from the Blood Center of Brasília, Brazil: focus on women of childbearing age / Avaliação sorológica e molecular do parvovírus B19 (B19V) em doadores de sangue da Fundação Hemocentro de Brasília, Brasil: foco em mulheres em idade fértil

ABSTRACT Parvovirus B19 (B19V) can be transmitted by the respiratory route, vertically - from the mother to the fetus - and via blood transfusion or organ transplantation. Infection by transfusion of blood or blood products occurs due to the resistance of B19V to viral inactivation methods. Our study evaluated the presence of B19V deoxyribonucleic acid (DNA) and the prevalence of anti-B19V class G immunoglobulin (IgG) in women of childbearing age blood donors of the Federal District, Brazil. Our results demonstrated the absence of B19V DNA in these blood donors. However, the seroprevalence for anti-B19V IgG was observed in 60.7% of this population. This study provides important data of B19V circulation in the Center-West of Brazil.

RESUMO O parvovírus B19 (B19V) pode ser transmitido por via respiratória, verticalmente - da mãe para o feto - e via transfusão de sangue e transplante de órgãos. A infecção por transfusão de sangue ou hemoderivados ocorre devido à resistência do B19V aos métodos de inativação viral. Nosso estudo avaliou a presença do ácido desoxirribonucleico (DNA) B19V e a prevalência de imunoglobulina da classe G (IgG) anti-B19V em mulheres em idade fértil, doadoras de sangue do Distrito Federal, Brasil. Nossos resultados demonstraram a ausência de DNA de B19V nesses doadores. No entanto, foi observada a soroprevalência de IgG anti-B19V em 60,7% dessa população. Este estudo fornece dados importantes da circulação do B19V no Centro-Oeste do Brasil.

Doenças hematológicas associadas ao eritrovírus / Hematologic diseases associated with eritrovírus

O eritrovírus infecta células precursoras eritroides, determinando a interrupção temporária da eritropoese. Neste contexto, é importante o conhecimento das principais doenças hematológicas que podem estar associadas à presença do vírus, principalmente quando estão presentes em condições mórbidas, tais como nas anemias hemolíticas hereditárias. Este trabalho tem como objetivo relatar as principais doenças hematológicas que cursam com a infecção pelo eritrovírus B19.

Erythroviruses infect precursor erythroid cells, determining a temporary disruption of erythropoiesis. Thus, knowledge of the main hematological diseases that may be associated with the virus is important, especially when they are present in morbid conditions, such as in hereditary hemolytic anemia. This paper aims at reporting the main hematological diseases that are associated with erythrovirus infections.

Síndrome hemofagocítico secundario a infección por Erythrovirus B19 y embarazo / Hemophagocytic syndrome secondary to infection Erythrovirus B19 and pregnancy

Antecedentes: El síndrome hemofagocítico es un desorden caracterizado por una proliferación benigna de los histiocitos y la fagocitosis de las células hematopoiéticas normales. Puede ocurrir por diversos estados de compromiso inmunológico o secundario a una gran variedad de infecciones. El comportamiento clínico puede presentarse desde una rápida recuperación hasta la muerte. Caso: Se descubrió una aplasia hematopoiética en una mujer de 27 años con 22 semanas de gestación sin factores de riesgo conocidos, presentando signos y síntomas aparentes de un síndrome purpúrico. La serología viral confirmó IgG e IgM positivos para Erythrovirus B19 y el aspirado de médula ósea demostró una hemofagocitosis reactiva con histiocitos y blastos afectando línea celular roja y blanca. El cuidado materno-fetal y el manejo conllevó al nacimiento de un recién nacido sin complicaciones. Conclusión: El diagnóstico del síndrome hemofagocítico durante el embarazo y el manejo oportuno de las complicaciones resultó en una adecuada resolución y éxito perinatal.

Background: Hemophagocytic syndrome is a hematologic disorder characterized by benign proliferation of histiocytes that undergo uncontrolled phagocytosis of normal hematopoietic cells. It can occur as a consequence of immunologic compromise or secondary of a wide range of infections. Clinical behavior can present from complete recovery to rapid deterioration and death. Case: Hematopoietic aplasia was discovered in a 27-year-old pregnant woman, gravida 2, at 22 weeks' gestation without known risk factors, presenting signs and symptoms of a purpuric syndrome. Confirmatory IgG and IgM Erythrovirus B19 viral serology was reported and bone marrow aspírate demonstrated reactive hemophagocytosis with histiocytes and blasts affecting red and white blood cell lines. Maternal-fetal assessment and management resulted in the delivery of a healthy newborn with an uncomplicated postpartum response. Conclusion: Oportune diagnosis of hemophagocytic syndrome during pregnancy and prompt management of its complications result in a marked resolution and perinatal success.

Hydrops Fetalis Due to Parvovirus B19 Infection: Report of Two Autopsy Cases

Hydrops fetalis (HF) is a disease characterized by generalized subcutaneous edema and cavity effusion in the fetal stage. We report here on two autopsy cases of HF that were caused by parvovirus B19 (PVB19) infection. The human PVB19 is an erythrovirus that cause diverse clinical manifestations ranging from an asymptomatic or mild presentation to more severe effects such as hydrops fetalis, and this is the only known human pathogenic parvovirus. The gestational ages of the two fetuses were 21 weeks and 23 weeks, respectively. Both fetuses were hydropic and anemic. Hepatic tissues of both fetuses demonstrated erythroblasts with eosinophilic intranuclear inclusions, the so called "lantern cells". PVB19 was confirmed by electron microscopy and immunohistochemical staining. For the diagnosis of this disease, recognition of parvovirus infection as a cause of hydrops fetalis and careful examination of red blood cells with a high-power view are required.