Rao S P, Miller S T, Cohen B J
Department of Pediatrics, State University of New York Children's Medical Center of Brooklyn 11203.
Am J Dis Child. 1992 Nov;146(11):1328-30. doi: 10.1001/archpedi.1992.02160230086025.
To determine (1) the proportion of cases of transient aplastic crisis (TAC) in patients with sickle cell disease due to B19 parvovirus infection in several years, (2) longitudinally, the immune response to B19 parvovirus infection, and (3) whether patients with sickle cell disease experience recurrent or chronic B19 parvovirus infection.
Prospective evaluation of patients with sickle cell disease and TAC to find evidence of B19 parvovirus infection and, if present, to document the pattern of serologic response with time.
Large urban teaching hospital.
Patients younger than 18 years with sickle cell disease who were admitted to the hospital with a diagnosis of TAC or who developed TAC while in the hospital for other reasons. Follow-up serologic studies of B19 parvovirus infection were done in eight patients.
MEASUREMENTS/MAIN RESULTS: Serum was tested for B19 parvovirus DNA/viral particles and specific anti-B19 parvovirus IgM and IgG antibodies. B19 parvovirus DNA/viral particles were detected in 11 (21%) of 53 patients with TAC. Specific anti-B19 parvovirus IgM antibodies were detected in 34 (64%) of the 53 patients. Overall, 36 (68%) of 53 patients with TAC had evidence of acute B19 parvovirus infection as shown by the detection of B19 DNA parvovirus and/or specific anti-B19 parvovirus IgM antibodies in acute-phase serum. Follow-up serologic studies in eight patients with acute infection revealed disappearance of B19 parvovirus DNA/viral particles and anti-B19 parvovirus IgM antibodies and persistence of anti-B19 parvovirus IgG antibodies for up to 3 1/2 years after the diagnosis of acute B19 parvovirus infection. No patient had evidence of recurrent or chronic B19 parvovirus infection.
Approximately 70% of cases of TAC in patients with sickle cell disease identified in a 7-year period were caused by acute B19 parvovirus infection. Once detected, anti-B19 parvovirus IgG antibodies remain detectable for several years. There was no evidence of chronic or recurrent B19 parvovirus infection in patients with sickle cell disease.
确定（1）数年间镰状细胞病患者因B19细小病毒感染导致的短暂再生障碍性危象（TAC）病例的比例；（2）纵向观察对B19细小病毒感染的免疫反应；（3）镰状细胞病患者是否经历复发性或慢性B19细小病毒感染。
对镰状细胞病和TAC患者进行前瞻性评估，以寻找B19细小病毒感染的证据，若存在感染，则记录血清学反应随时间变化的模式。
大型城市教学医院。
年龄小于18岁的镰状细胞病患者，因诊断为TAC入院或因其他原因住院期间发生TAC。对8例患者进行了B19细小病毒感染的随访血清学研究。
测量指标/主要结果：检测血清中的B19细小病毒DNA/病毒颗粒以及特异性抗B19细小病毒IgM和IgG抗体。在53例TAC患者中，11例（21%）检测到B19细小病毒DNA/病毒颗粒。53例患者中有34例（64%）检测到特异性抗B19细小病毒IgM抗体。总体而言，53例TAC患者中有36例（68%）有急性B19细小病毒感染的证据，表现为急性期血清中检测到B19细小病毒DNA和/或特异性抗B19细小病毒IgM抗体。对8例急性感染患者的随访血清学研究显示，急性B19细小病毒感染诊断后长达3年半的时间里，B19细小病毒DNA/病毒颗粒和抗B19细小病毒IgM抗体消失，抗B19细小病毒IgG抗体持续存在。没有患者有复发性或慢性B19细小病毒感染的证据。
在7年期间确诊的镰状细胞病患者中，约70%的TAC病例由急性B19细小病毒感染引起。一旦检测到，抗B19细小病毒IgG抗体可在数年内检测到。没有证据表明镰状细胞病患者存在慢性或复发性B19细小病毒感染。
