RHEUMATOLOGIC MANIFESTATIONS OF PARVOVIRU S B19 INFECTION

Parvoviruses are small single-strand DNA viruses, Human parvovirus (PV B19) was isolated in the 1970s and recognized as a pathogen in the 80 s. Its role was first demonstrated in acute erythroblastopenia in pati ents with chronic haemolytic anaemia, then in epidemic megalerythema. More recently PVB19 has been shown to be the aetiologic agent in fetal loss and chronic infection in immunodepressed patients, Further atten tion has focused on rheumatologic manifestations, particularly in prol onged joint diseases raising the problem of differential diagnosis and a possible pathogenic relationship with rheumatoid arthritis and syst emic lupus erythematosus. Clinically, subjects with parvovirus B19 inf ection have flu-like manifestations of joint pain and myalgia lasting for about 1 week. Generally, the joint pain is symmetrical, of inflamm atory type usually involving proximal joints (phalangeal joints in two -thirds of the cases). Acute back pain or associated extra-articular s igns are often absent. Signs regress spontaneously in 10 to 15 days al though longer periods have been observed. Diagnosis can be confirmed b y ELISA identification of specific IgM antibodies. Nonsteroid antiinfl ammatory drugs are generally effective.