Zaki Maysaa El Sayed, Hassan Samir AbouEl, Seleim Tarek, Lateef Rania AbdEl
Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Hematology. 2006 Aug;11(4):261-6. doi: 10.1080/10245330600841089.
This study was carried out to detect Parvovirus B19 (PB19) DNA together with its antibodies in the sera of children with a range of hematological disorders to clarify the contribution of this infection to changes observed in hematological picture in those populations. This study included 85 pediatric patients with different hematological disorders. Twenty healthy subjects with matched age and sex were included as controls. Patients were classified into four groups; group I included 25 patients with hemolytic anemia in aplastic crisis, group II included 20 patients with hemolytic anemia without aplastic crisis, group III included 20 acute leukemia patients under chemotherapy, group IV included 20 patients with recently diagnosed acute leukemia. Virological study for PB19 included determination of specific IgG & IgM together with viral DNA by polymerase chain reaction (PCR). In all groups of patients with positive markers for PB19, there were statistically significant differences in the mean Hb concentration and RBC count (P < 0.001 for each), presence of neutropenia (P = 0.003) and lymphocytosis (P < 0.001) compared to controls. There was statistically significant difference in the prevalence of PB19 IgM, IgG and PCR among studied groups compared to control group. In group I and group II IgG had the highest positive rate (56 and 35%, respectively). In group III IgG also had a high positive rate (45%). However, in group IV IgM had the highest positive rate (50%) followed by PCR (45%) then IgG (40%). In conclusion, PB19 infection is detected in high rates among children with hematological disorders. PB19 must be suspected and screened for when there is anemia in those patients associated with neutropenia and lymphocytosis. In patients with acute leukaemia under chemotherapy who have unexpected anemia, neutropenia and lymphocytosis Parvovirus infection should be considered before a change of chemotherapy protocol. Screening of blood for PB19 may be helpful in understanding the epidemiology of infection with this virus. The direct detection of DNA by PCR in sera needs to be coupled with serology for a more reliable diagnosis of PB19 infections in these children.
本研究旨在检测一系列血液系统疾病患儿血清中的细小病毒B19（PB19）DNA及其抗体，以阐明这种感染对这些人群血液学表现变化的影响。本研究纳入了85例患有不同血液系统疾病的儿科患者。选取20例年龄和性别匹配的健康受试者作为对照。患者分为四组：第一组包括25例再生障碍危象中的溶血性贫血患者，第二组包括20例无再生障碍危象的溶血性贫血患者，第三组包括20例正在接受化疗的急性白血病患者，第四组包括20例新诊断的急性白血病患者。PB19的病毒学研究包括通过聚合酶链反应（PCR）测定特异性IgG和IgM以及病毒DNA。在所有PB19标志物呈阳性的患者组中，与对照组相比，平均血红蛋白浓度和红细胞计数（每项P < 0.001）、中性粒细胞减少症的存在（P = 0.003）和淋巴细胞增多症（P < 0.001）存在统计学显著差异。与对照组相比，研究组中PB19 IgM、IgG和PCR的患病率存在统计学显著差异。在第一组和第二组中，IgG的阳性率最高（分别为56%和35%）。在第三组中，IgG的阳性率也较高（45%）。然而，在第四组中，IgM的阳性率最高（50%），其次是PCR（45%），然后是IgG（40%）。总之，在血液系统疾病患儿中检测到PB19感染的比率较高。当这些患者出现与中性粒细胞减少症和淋巴细胞增多症相关的贫血时，必须怀疑并筛查PB19。在接受化疗的急性白血病患者中，如果出现意外的贫血、中性粒细胞减少症和淋巴细胞增多症，在改变化疗方案之前应考虑细小病毒感染。对血液进行PB19筛查可能有助于了解这种病毒的感染流行病学。通过PCR直接检测血清中的DNA需要结合血清学检查，以便更可靠地诊断这些儿童的PB19感染。
