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对埃及镰状细胞病患儿细小病毒 B-19 感染的分子和血清学评估。

Molecular and serological assessment of parvovirus B-19 infection in Egyptian children with sickle cell disease.

机构信息

Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.

Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.

出版信息

J Microbiol Immunol Infect. 2017 Oct;50(5):565-569. doi: 10.1016/j.jmii.2015.10.016. Epub 2015 Dec 1.

Abstract

BACKGROUND/PURPOSE: Human parvovirus B-19 (PB-19) is a cause of hemolysis, red blood cell aplasia, and severe conditions in patients with sickle cell anemia, but the molecular mechanisms of the infection are still insufficiently understood. This study aimed to detect PB-19 DNA together with its antibodies in the sera of Egyptian children with sickle cell disease and to assess the contribution of this infection, which causes transient cessation of erythropoiesis, in precipitating severe anemia in some cases.

METHODS

One hundred children with sickle cell disease seeking medical advice in the pediatric-hematology clinic were recruited. Sera of the patients were compared with those of 60 healthy children regarding the presence of PB-19 immunoglobulin (Ig)G and IgM as well as detection of its DNA by nested-polymerase chain reaction technique.

RESULTS

There were statistically significant differences in the prevalence of PB-19 IgM, IgG, and DNA among patients when compared with controls (p < 0.001, p = 0.001, and p < 0.001 respectively). Acute PB-19 infection detected by positive IgM and DNA was found in 30% of the patients, while chronic PB-19 infection detected by positive IgG and DNA was detected in 24% of the patients. Anemia was worse in children with acute PB-19 infection than in those with chronic infection, while anemia was mild in children with old infection.

CONCLUSION

PB-19 infection is detected at high rates among Egyptian children with sickle cell disease and it may result in severe anemia. So, PB-19 must be suspected and screened for in such group of patients.

摘要

背景/目的:人类细小病毒 B-19(PB-19)是导致镰状细胞贫血患者发生溶血、红细胞再生障碍和严重病症的原因,但这种感染的分子机制仍了解不足。本研究旨在检测埃及镰状细胞病儿童血清中的 PB-19 DNA 及其抗体,并评估这种感染(可导致红细胞生成暂时停止)在某些情况下引发严重贫血的作用。

方法

招募了 100 名在儿科血液科诊所就诊的镰状细胞病儿童。将患者的血清与 60 名健康儿童的血清进行比较,以检测 PB-19 免疫球蛋白(Ig)G 和 IgM 的存在情况,并通过巢式聚合酶链反应技术检测其 DNA。

结果

与对照组相比,患者的 PB-19 IgM、IgG 和 DNA 的流行率存在统计学差异(p<0.001、p=0.001 和 p<0.001)。通过阳性 IgM 和 DNA 检测到 30%的患者存在急性 PB-19 感染,而通过阳性 IgG 和 DNA 检测到 24%的患者存在慢性 PB-19 感染。急性 PB-19 感染的儿童贫血程度比慢性感染的儿童更严重,而陈旧感染的儿童贫血程度较轻。

结论

埃及镰状细胞病儿童中存在高比例的 PB-19 感染,并且可能导致严重贫血。因此,在这类患者中必须怀疑并筛查 PB-19 感染。

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