Spectrum of parvovirus B19 infection: analysis of an outbreak of 43 cases in Cadiz, Spain.

In the spring of 1993, an epidemic of infection with human parvovirus B19 occurred in Cadiz, Spain. Evaluation of the 43 patients in whom this diagnosis was confirmed revealed four groups of predominant manifestations: (1) hematologic manifestations in six cases (13.9%), including four of aplastic crisis and two of pancytopenia; (2) dermatologic manifestations in 23 cases (53.4%), including 10 of erythema infectiosum and one of erythema multiforme ampullosum; (3) arthralgias/arthritis in nine cases (20.9%), including two with a chronic course; and (4) infection during pregnancy in three cases (7.0%), including two that ended in abortion. Of the 43 patients, 37.2% presented with fever and adenopathies, and these were the only manifestations in two cases. The appearance of clinical disease correlated with modifications in isotype and serum level of specific antibodies to parvovirus B19; the disappearance of IgM antibodies coincided with the resolution of clinical manifestations. Although their presence did not correlate with the course of the disease, the detection of circulating immune complexes in 81.6% of cases supports the possibility that some manifestations were immune mediated.

[Erythrocyte reference values in a Coulter S-Plus STKR, in healthy adults living at 2,240 meters above sea level]. / Límites de referencia de serie roja, obtenidos en el equipo Coulter S-plus STKR, en adultos sanos residentes a 2,240 metros sobre el nivel del mar.

To determine reference values of red blood cell counts in a Coulter S-Plus STKR, we studied 122 males and 147 females selected from the hospital staff (physicians, chemists, nurses) and blood donors. Their ages ranged from 17 to 45 years. Iron and total iron binding capacity in serum, and Zn-protoporphyrin and folates in erythrocytes were measured to include only normal subjects without nutritional deficiencies. Two males (1.6%) and 21 females (14.3%) were excluded due to iron deficiency, and one man (0.7%) and one woman (0.8%) to folate deficiency. All red cell parameters, except the mean cell volume, showed a gaussian distribution (Lilliefors test). Their mean +/- standard deviation were: [formula: see text].

[Obtaining a reference pattern of rabbit brain thromboplastin]. / La obtención de un patrón de referencia de tromboplastina de cerebro de conejo.

Thromboplastin is a tissue extract used in the prothrombin time test (PT) necessary for oral anticoagulant control. The interlaboratory variability of the results of the PT test with thromboplastins of different tissue types, besides differences due to reporting PT in seconds or percentage, indicate the need for a standardized reference thromboplastin in order to express PT results on a common scale. The aim of the present work is to encourage the laboratory hospital either singly or in regional groups, to produce a standardized thromboplastin for their own use, to insure the control of oral anticoagulant therapy. Rabbit brain thromboplastin was prepared by Quick's technique. The reagent was calibrated against the international reference thromboplastin RBT/079, following the recommendations of the World Health Organization (WHO). Statistical analyses of the data were performed using an orthogonal regression. We obtained an international sensitivity index (ISI) of 2.177, a standard error of 0.0454 and a coefficient of variation of 2.09%. An international normalized ratio (INR) was also obtained for the conversion of measured PT to a common scale. The INNSZ thromboplastin is the first national reference preparation. With this reagent the introduction of an international scale for the control of oral anticoagulant therapy has become feasible in our country.