Human parvovirus B19 infection: its role in acute arthropathies

ABSTRACT

Viral infections have a number of important effects on the immune system. Infection with human parvovirus B19 [B19] has a diverse range of clinical manifestations including erythema infectiosum, polyarthropathy, transient aplastic crisis, hydrops fetalis and fetal death as well as chronic infection and anemia in immunocompromised hosts. Since its discovery in 1975, it has been noted that HPV B19 frequently causes a self-limiting polyarthritis in adults. It has also been debated whether, in some patients, B19 may act as a trigger for RA. The aim was to determine the incidence and significance of antibodies to the parvovirus B19, we detected the presence of B19 IgM and IgG antibodies in 40 rheumatoid arthritis [RA] patients, 10 SLE patients, 10 osteoarthritis patients and 30 normal adults. B19 IgM was positive in 60% of RA patients. This rate was significantly higher than the control group. They were mostly females [70%], duration of illness was 3 months to one year [68.7%] with polyarthritis, large and small joints were more affected [72.7%] with manifestations of acute inflammation. Rheumatoid factor [RF] was negative in 70% of them. Regarding osteoarthritis patients, B19 IgM antibodies were detected in 40% of them. They were females [60%] with polyarthritis, large and small joints were more affected [75%]. On the other hand B19 IgM antibodies were not detected in SLE patients or in the control group. Parvovirus B19 is important viral agent causing joint manifestations and should be considered in the differential diagnosis of acute arthropathy in adults, as early treatment of these cases results in fewer complications