Jacquot R, Gerfaud-Valentin M, Mekki Y, Billaud G, Jamilloux Y, Sève P
Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université de Lyon, Lyon, France.
Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université de Lyon, Lyon, France.
Rev Med Interne. 2022 Dec;43(12):713-726. doi: 10.1016/j.revmed.2022.08.005. Epub 2022 Sep 8.
Acute Parvovirus B19 (PVB19) infection is responsible for erythema infectiosum in children and non-specific polyarthralgias in immunocompetent adults associated with skin lesions and rarer manifestations (hepatic, neurological, cardiac or nephrological). In immunocompromised patients, cytopenias are more frequent and in some cases, viremia persists and is responsible for PVB19 chronic infection. PVB19 is responsible for pure red cell aplasia during chronic hemolytic diseases. Acute PVB19 infection is a differential diagnosis of some autoimmune diseases and has been suspected to be a trigger for some autoimmune diseases because of its ability to promote the emergence of autoimmune markers. Mechanisms of molecular mimicry, induction of apoptosis and activation of enzymes have been demonstrated, explaining in part the production of autoantibodies during infection. However, the demonstration of a causal relationship in the triggering of autoimmune disease remains to be done. This review provides a synthesis of the PVB19 infection clinical data in adults with a particular focus on these links with autoimmunity.
急性B19微小病毒(PVB19)感染可导致儿童患传染性红斑以及免疫功能正常的成年人出现非特异性多关节痛,并伴有皮肤病变和罕见表现(肝脏、神经、心脏或肾脏方面)。在免疫功能低下的患者中,血细胞减少更为常见,在某些情况下,病毒血症持续存在并导致PVB19慢性感染。PVB19可导致慢性溶血性疾病期间出现纯红细胞再生障碍。急性PVB19感染是一些自身免疫性疾病的鉴别诊断,并且由于其促进自身免疫标志物出现的能力,已被怀疑是某些自身免疫性疾病的触发因素。分子模拟、凋亡诱导和酶激活的机制已得到证实,部分解释了感染期间自身抗体的产生。然而,自身免疫性疾病触发中因果关系的证明仍有待完成。本综述综合了成人PVB19感染的临床数据,特别关注其与自身免疫的这些联系。