Karmochkine M
Service de médecine interne, CHU Pitié-Salpêtrière, Paris, France.
Rev Med Interne. 1995;16(12):905-12. doi: 10.1016/0248-8663(96)80811-3.
Pathogenicity of parvovirus B19 has been demonstrated. The spectrum of clinical manifestations varies according to the age and immune status of affected patients. Parvovirus B19 is the aetiologic agent of erythema infectiosum in children. In normal adults, it is responsible for acute, bilateral and symmetrical arthritis, although chronic arthritis can develop. Parvovirus B19 has a particular tropism for erythroid precursors: in patients with underlying hemolysis, it induces transient aplastic crisis; in immunosuppressed patients the virus can lead to chronic pure red cell aplasia. Hydrops fetalis is one of the most severe manifestation of the infection. Diagnosis of recent parvovirus B19 infection is based upon serology and PCR, especially in immunosuppressed patients in whom polyvalent intravenous immunoglobulins must be started. The link between parvovirus B19 and systemic vasculitis is questioned.
细小病毒B19的致病性已得到证实。临床表现的范围因受影响患者的年龄和免疫状态而异。细小病毒B19是儿童传染性红斑的病原体。在正常成年人中,它会导致急性、双侧对称的关节炎,尽管也可能发展为慢性关节炎。细小病毒B19对红系前体细胞有特殊的嗜性:在有潜在溶血的患者中,它会引发短暂的再生障碍危象;在免疫抑制患者中,该病毒可导致慢性纯红细胞再生障碍。胎儿水肿是该感染最严重的表现之一。近期细小病毒B19感染的诊断基于血清学和聚合酶链反应(PCR),特别是在必须开始使用多价静脉注射免疫球蛋白的免疫抑制患者中。细小病毒B19与系统性血管炎之间的联系存在疑问。