RESUMO
To determine the frequency and the impact of parvovirus B19 (B19V) infection and its influence on the course of haematological and/or oncological diseases in paediatric patients, consecutive serum and bone marrow samples from 110 were analyzed for markers of acute, past and persistent B19V-infection using qPCR, ELISA and WesternLine. Twenty-seven out of 110 (24.5%) children suffered from non-malignant diseases (anaemia, pancytopenia, autoimmune disorders); 68/110 (61.8%) patients had developed leukaemia, malignant lymphoma or solid malignant tumours; 15/110 patients (13.6%) presented with other symptoms. At admission, B19V-specific IgM and IgG indicating acute or previous B19V-infection were observed in 5 (4.5%) and 48 patients (43.6%), respectively. B19V-DNA (10(3) -10(9) geq/mL) was detectable in serum and/or bone marrow of 22 patients (20.0%). These suffered from leukaemia (5), non-Hodgkin lymphoma (2), solid tumours (6), autoimmune (4) and haematological (4) disease and fever (1). During clinical observation four further leukaemia patients developed viraemia and persistent B19V-infection was observed in 13/22 DNA-positive patients. Treatment of B19V-DNA-positive cancer patients was associated with more supportive therapy involving erythrocyte and thrombocyte transfusion and/or antibiotic therapy. Acute B19V-infection has been frequently observed in paediatric patients with haematological and/or oncological disease. In patients with non-malignant diseases anaemia or autoimmune disorders were diagnosed in association with B19V-infection. Furthermore, a significant number of cancer patients displayed markers for acute, recent or persistent B19V-infection. This association may be strengthened by frequent treatment with blood products combined with therapeutic immune suppression. In B19V-infected cancer patients supportive therapy was more complex.
Assuntos
Neoplasias Hematológicas/virologia , Neoplasias/virologia , Infecções por Parvoviridae/sangue , Infecções por Parvoviridae/complicações , Parvovirus B19 Humano/isolamento & purificação , Adolescente , Anticorpos Antivirais/análise , Anticorpos Antivirais/sangue , Biomarcadores/análise , Biomarcadores/sangue , Medula Óssea/virologia , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Estudos de Coortes , DNA Viral , Feminino , Neoplasias Hematológicas/sangue , Humanos , Lactente , Masculino , Neoplasias/sangue , Transplante de Células-Tronco , Adulto JovemRESUMO
BACKGROUND: Novel PCR techniques can detect minute quantities of herpesvirus DNA in cerebrospinal fluid (CSF). The clinical significance of such findings is not always clear. PATIENTS AND METHODS: (a) Investigation of clinical characteristics of 76 patients with herpesvirus DNA detection in CSF. (b) Screening for herpesvirus DNA in CSF samples of 208 patients without clinical signs of herpesvirus infection. RESULTS: (a) Eleven of 76 herpesvirus-DNA-positive patients did not show symptoms usually associated with the detected virus (HSV-1/2, n = 5; EBV, n = 6). (b) Two of 208 patients without hint for herpesvirus infection had HHV-6 DNA of low concentration in CSF. CONCLUSIONS: The detection of low-level herpesvirus replication in CSF by highly sensitive PCR assays requires critical evaluation.
Assuntos
DNA Viral/líquido cefalorraquidiano , Infecções por Herpesviridae/virologia , Herpesviridae/isolamento & purificação , Anticorpos Antivirais/sangue , Anticorpos Antivirais/líquido cefalorraquidiano , Citomegalovirus/genética , Citomegalovirus/isolamento & purificação , Ensaio de Imunoadsorção Enzimática , Herpesviridae/genética , Herpesviridae/imunologia , Infecções por Herpesviridae/líquido cefalorraquidiano , Infecções por Herpesviridae/imunologia , Herpesvirus Humano 1/genética , Herpesvirus Humano 1/isolamento & purificação , Herpesvirus Humano 2/genética , Herpesvirus Humano 2/isolamento & purificação , Herpesvirus Humano 3/genética , Herpesvirus Humano 3/isolamento & purificação , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/isolamento & purificação , Herpesvirus Humano 6/genética , Herpesvirus Humano 6/isolamento & purificação , Humanos , Reação em Cadeia da PolimeraseRESUMO
Hepatitis E virus (HEV) is a common cause of acute hepatitis in endemic areas. Yet reports on autochthonous cases in other areas such as middle Europe are increasing. Here we report on a patient, who obviously acquired his HEV infection in Germany. Sequence analysis of the virus gained from his serum revealed homologies to other European isolates and swine isolates.
