Heegaard E D, Myhre J, Hornsleth A, Gundestrup M, Boye H
Department of Virology, University of Copenhagen, Denmark.
Haematologica. 1997 Jul-Aug;82(4):402-5.
Parvovirus B19 has a marked tropism for erythroid progenitor cells and this may lead to chronic anemia in predisposed individuals. It was the purpose of the present study to investigate prospectively the frequency of parvovirus B19 infections in patients with a diagnosis of chronic anemia.
Evidence of parvovirus B19 infection was found in 13/43 (30%) patients by demonstrating viral DNA and/or specific IgM antibodies through the use of PCR and ELISA techniques. Parvovirus B19 infection was established in 4 of 7 patients with hemolytic anemia, in 2 of 3 patients with pure red cell aplasia, in 2 of 9 patients with myelodysplastic syndrome, and in 2 of 10 patients with aplastic anemia. In 8 of the 13 positive patients only parvovirus B19 DNA could be detected, while 4 patients tested positive for both parvovirus B19 DNA and specific IgM. In the remaining positive patient only specific IgM could be detected.
Since no predictive paraclinical or clinical features were observed we recommend that all cases of chronic anemia be tested for the presence of parvovirus B19 infection. Due to the discrepancies between DNA and IgM results, the diagnostic procedures should include a search for specific DNA by PCR methods if specific IgM has been found to be negative.
细小病毒B19对红系祖细胞具有显著的嗜性,这可能导致易感个体出现慢性贫血。本研究的目的是前瞻性地调查诊断为慢性贫血的患者中细小病毒B19感染的频率。
通过使用PCR和ELISA技术检测病毒DNA和/或特异性IgM抗体,在13/43(30%)的患者中发现了细小病毒B19感染的证据。在7例溶血性贫血患者中有4例、3例纯红细胞再生障碍性贫血患者中有2例、9例骨髓增生异常综合征患者中有2例以及10例再生障碍性贫血患者中有2例确诊为细小病毒B19感染。在13例阳性患者中,8例仅检测到细小病毒B19 DNA,4例细小病毒B19 DNA和特异性IgM均呈阳性。在其余阳性患者中仅检测到特异性IgM。
由于未观察到预测性的临床前或临床特征,我们建议对所有慢性贫血病例进行细小病毒B19感染检测。鉴于DNA和IgM结果存在差异,如果发现特异性IgM为阴性,诊断程序应包括通过PCR方法寻找特异性DNA。