Department of General Internal Medicine, Rakuwakai Otowa Hospital, Otowachinji-cho 2, Yamashina-ku, Kyoto, 607-8062, Japan.
Mod Rheumatol. 2011 Feb;21(1):24-31. doi: 10.1007/s10165-010-0338-y. Epub 2010 Aug 4.
To relate the clinical findings of parvovirus B19 infection to the phase of the disease, we performed a retrospective chart review of 30 adult patients who tested positive for IgM antibody against parvovirus B19 at our hospital from March 2003 to November 2008. Median patient age was 38 years, with 86.7% aged between 26 and 45 years. The male-to-female ratio was 4:26 (86.7% female). Symptoms in the first phase were mainly flu-like, including fever, headache, or myalgia. Symptoms in the second phase were arthralgia in 24 (85.7%) and rash in 23 (82.1%). Fever was observed in 21 (70.0%), and 22 (75.9%) were found to be lymphopenic. The onsets in 73.3% of cases were concentrated within 10.1% of the study period, an observation nearly consistent with an outbreak of erythema infectiosum. Three patients had symmetrical swelling of joints, all of whom also had rash. Most patients visited the hospital within a week of onset and prognosis was favorable. In the parvovirus B19 infection, flu-like symptoms were frequent in the first phase, while rash and arthralgia were common in the second. Female sex, age between 26 and 45, and presence of rash, arthralgia, fever, and lymphopenia were clinical findings with a high frequency (≥70%), and these factors may contribute to diagnosis. In an era when early diagnosis and therapy is required in rheumatoid arthritis, it is important to recognize the parvovirus B19 infection with a presentation of acute arthritis and a favorable prognosis.
为了将细小病毒 B19 感染的临床发现与疾病阶段联系起来，我们对 2003 年 3 月至 2008 年 11 月在我院检测出细小病毒 B19 IgM 抗体阳性的 30 例成年患者进行了回顾性图表审查。患者的中位年龄为 38 岁，26 至 45 岁之间的患者占 86.7%。男女比例为 4:26（86.7%为女性）。第一阶段的症状主要为流感样，包括发热、头痛或肌痛。第二阶段的症状为 24 例（85.7%）出现关节痛和 23 例（82.1%）出现皮疹。21 例（70.0%）出现发热，22 例（75.9%）出现淋巴细胞减少。73.3%的发病时间集中在研究期间的 10.1%内，这一观察结果几乎与传染性红斑的爆发一致。3 例患者关节出现对称性肿胀，均伴有皮疹。大多数患者在发病后一周内就诊，预后良好。在细小病毒 B19 感染中，第一阶段常出现流感样症状，而皮疹和关节痛在第二阶段常见。女性、26 至 45 岁之间的年龄、皮疹、关节痛、发热和淋巴细胞减少的存在具有较高的频率（≥70%），这些因素可能有助于诊断。在需要早期诊断和治疗类风湿关节炎的时代，认识到细小病毒 B19 感染具有急性关节炎和良好预后的表现非常重要。
