Rheumatic manifestations due to human parvovirus B19. A report of four cases.

Human parvovirus B19 has been incriminated in the genesis of hematologic, dermatologic, neurologic, and rheumatic disorders. We report four cases in which inflammatory rheumatic manifestations developed during the course of human parvovirus B19 infection documented by the presence of IgM and IgG antibodies. There was one case each of monoarthritis, oligoarthritis, polyarthritis, and enthesitis. Three patients had a favorable outcome under nonsteroidal antiinflammatory drug therapy, and one developed reflex sympathetic dystrophy syndrome. In patients with inflammatory rheumatic manifestations that do not fit any specific diagnosis, a careful family history can provide evidence suggesting human parvovirus B19 infection, which should be confirmed by tests for IgM and IgG antibodies.