Işik Nilgün, Ağaçfidan Ali, Ağirbaşli Handan, Işik D Murat, Bozkaya Emel, Gedikoğlu Gündüz, Badur Selim
Istanbul Universitesi Istanbul Tip Fakültesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dali, Capa, Istanbul.
Mikrobiyol Bul. 2003 Oct;37(4):277-83.
Human parvovirus B19 (PV-B19) infection may lead to very serious clinical situations such as transient aplastic crisis in patients with hemolytic anemia, thrombocytopenia, neutropenia and transient arthritis accompanied with erythema infectiosum, especially in immunosuppressed patients. Early diagnosis of PV-B19 infection is of critical importance especially in immunosuppressed patients since the necessary precautions can be undertaken accordingly. In this study, PV-B19 IgM and IgG antibodies and viral DNA have been searched by enzyme immunoassay (ELISA) and real-time polymerase chain reaction (PCR), respectively, in 50 PV-B19 suspected immunosuppressed patients. Viral IgM, IgG and DNA positivities were detected in 7 (14%), 20 (40%) and 7 (14%) of the patients, respectively. During the first week three patients were found DNA and IgM positive but IgG negative, while four patients were found positive for the viral DNA, IgM and IgGs. The DNA copy numbers were high in all of the patients during the first week, with a gradual decrease during a seven-week follow-up period. IgM antibodies have disappeared in the sixth week in three of the patients and at the end of the seventh week in four of the patients. Although the IgG antibodies were negative in three patients in the first week, they became positive in the second week and the titers gradually increased during the following weeks. According to the results of this study, it can be concluded that, in high risk groups such as immunosuppressed patients, in addition to ELISA, real-time PCR method would be helpful for the early diagnosis of PV-B19 infections.
人细小病毒B19(PV-B19)感染可能导致非常严重的临床情况,如溶血性贫血患者出现的短暂再生障碍危象、血小板减少、中性粒细胞减少以及伴有传染性红斑的短暂关节炎,尤其是在免疫抑制患者中。PV-B19感染的早期诊断至关重要,特别是对于免疫抑制患者,因为可以据此采取必要的预防措施。在本研究中,分别通过酶免疫测定(ELISA)和实时聚合酶链反应(PCR)对50例疑似PV-B19感染的免疫抑制患者检测了PV-B19 IgM和IgG抗体以及病毒DNA。分别在7例(14%)、20例(40%)和7例(14%)患者中检测到病毒IgM、IgG和DNA阳性。在第一周,3例患者被发现DNA和IgM阳性但IgG阴性,而4例患者被发现病毒DNA、IgM和IgG均为阳性。所有患者在第一周时DNA拷贝数都很高,在为期7周的随访期间逐渐下降。3例患者的IgM抗体在第6周消失,4例患者在第7周结束时消失。虽然3例患者在第一周时IgG抗体为阴性,但在第二周转为阳性,且在随后几周滴度逐渐升高。根据本研究结果,可以得出结论:在免疫抑制患者等高风险人群中,除ELISA外,实时PCR方法有助于PV-B19感染的早期诊断。