[Parvovirus B19 infections. The cause of fifth disease-erythema infectiosum--can also cause aplastic crises, fetal damage and polyarthritis].

Human parvovirus B19 can be an important etiological factor in aplastic crises in patients with chronic hemolytic anemia, in fetal damage, and in acute polyarthritis. B19-virus can only be grown in cell cultures established from human bone marrow, where the virus production occurs in erythroblasts. Parvovirus can cause severe, often fatal, infections in various kinds of animals, also in their fetuses, and many cases of teratogenic changes have been described. The B19-infection is diagnosed by demonstration of either IgM antibodies or B19-DNA in serum samples obtained in the early phases of infection. Patients with EI are infectious before skin eruptions occur, i.e. in the prodromal phase where virus can be detected in respiratory secretion. Transmission of the infection by concentrated, heat-treated factor preparations has been reported. Acute polyarthritis accompanying B19-infections has most often been described to affect the finger, hand and knee joints in adult women. Maternal B19-infections can be complicated by intrauterine infections damaging the fetus and resulting in abortion, hydrops fetalis or stillbirth. The B19-infection has not with certainty been found to be teratogenic. Recent studies seem to show that about 10-20% of primary maternal infections can be complicated by fetal damage, but until further this percentage should be regarded with great reservation.