Smith M A, Ryan M E
Pediatric Branch, National Cancer Institute, Bethesda.
Postgrad Med. 1988 Nov 15;84(7):127-8, 131-4. doi: 10.1080/00325481.1988.11700498.
Erythema infectiosum, aplastic crisis, intrauterine fetal demise, and an acute polyarthralgia syndrome can all be caused by human parvovirus B19. The major pathophysiologic effect of infection seems to be cessation of erythropoiesis as a result of cytolytic infection of red cell precursors. Erythema infectiosum is a benign disease that usually occurs in childhood. The acute polyarthralgia syndrome is likewise benign, and patients in whom parvovirus infection has been confirmed by serologic testing can be reassured that their joint symptoms are likely to be self-limited. Parvovirus-induced aplastic crisis in a patient with chronic hemolytic anemia is life-threatening but can be reversed with blood transfusions if recognized promptly. Parvovirus infection during pregnancy clearly increases the risk of fetal demise, and parental anxiety is understandably high. An organized approach using a combination of tests to monitor mother and fetus can provide optimal care in these cases.
传染性红斑、再生障碍性危象、宫内胎儿死亡以及急性多关节痛综合征均可由人细小病毒B19引起。感染的主要病理生理效应似乎是由于红细胞前体细胞的溶细胞性感染导致红细胞生成停止。传染性红斑是一种通常发生在儿童期的良性疾病。急性多关节痛综合征同样是良性的，通过血清学检测确诊为细小病毒感染的患者可以放心，其关节症状可能会自行缓解。慢性溶血性贫血患者发生细小病毒引起的再生障碍性危象会危及生命，但如果能及时识别，通过输血可使其逆转。孕期感染细小病毒显然会增加胎儿死亡的风险，父母的焦虑情绪可想而知。在这些情况下，采用联合检测的有条理的方法来监测母亲和胎儿，可为其提供最佳护理。
