Acute coagulopathy associated with parvovirus B19 infection: case report and review of atypical B19 infection in multisystem rheumatological disease

Parvovirus B19 is the only known parvovirus that is pathogenic to humans. I n healthy individuals the major symptomatic presentation is erythema infect iosum, although acute infection can present in other forms, such as polyart hropathy or aplastic crisis. Persistent viral infection in the immunocompro mised host has been increasingly recognized as a cause of chronic anaemia. Attempts have been made to link atypical parvovirus B19 infection with a wi de variety of other clinical conditions including a number of rheumatologic al presentations. We describe a novel association between acute B19 infecti on and a case of severe coagulopathy. The clinical course and treatment are described and possible aetiological mechanisms discussed, followed by a re view of the evidence implicating atypical parvovirus B19 infection in the a etiology of diverse multisystem rheumatological diseases such as systemic l upus erythamatosus and the necrotising vasculitides. (C) 1999 Lippincott Wi lliams & Wilkins.