Wada Y, Kobayashi M, Kubo M
Department of Pediatrics, Kashiwa Hospital, Tokyo Jikei University. School of Medicines, Kashiwa-city, Chiba.
Kansenshogaku Zasshi. 1997 May;71(5):468-73. doi: 10.11150/kansenshogakuzasshi1970.71.468.
We encountered a case of a girl where Human Parvovirus B19 infection was considered to have been concerned with the development of systemic type juvenile rheumatoid arthritis (JRA). While the affected child did not show any evident infectious erythema-like findings, changes in the serum antibody titer by the EIA method presented the pattern of first infection. During the clinical course the condition of the disease as JRA was serious and hemophagocytic syndrome developed concurrently. Furthermore, the resistance to the treatment was also noted. So the patient was treated with prednisolone combined with low dose weekly MTX therapy. The possibility of Human parvovirus B19 being concerned with the development of rheumatoid arthritis in one form or another has been suggested in recent years. In the disease type with systemic angititis as main pathophysiology, which is called systemic JRA we encountered this time, it is not clear how Human Parvovirus B19 was concerned with the development of this disease, but it appeared to hold a key position in studying pathophysiology of the development.
我们遇到一例女童病例，其中人细小病毒B19感染被认为与全身性幼年类风湿性关节炎（JRA）的发病有关。虽然患病儿童未表现出任何明显的传染性红斑样表现，但采用酶免疫测定法检测血清抗体滴度的变化呈现出初次感染的模式。在临床病程中，该疾病作为JRA病情严重，同时并发噬血细胞综合征。此外，还注意到对治疗的抵抗性。因此，对该患者采用泼尼松龙联合小剂量每周一次甲氨蝶呤治疗。近年来，已有人提出人细小病毒B19可能以某种形式与类风湿性关节炎的发病有关。在我们此次遇到的以系统性血管炎为主要病理生理学特征的疾病类型，即全身性JRA中，尚不清楚人细小病毒B19如何与该疾病的发病相关，但它似乎在研究发病的病理生理学方面占据关键地位。
