Cytopenia and past human parvovirus B19 infection in patients with primarySjogren's syndrome

Objectives: To determine the clinical significance of human parvovirus B19 infection in patients with primary Sjogren's syndrome (SS) and to investiga te the immunologic and hematologic features related to B19 infection. Methods: We included 80 consecutive patients with primary SS (74 women and 6 men), with a mean age of 62 years (range, 24 to 87 years) that were seen in our Unit. All patients fulfilled the European Community criteria for SS. As controls, we included 140 consecutive sera samples analyzed for B19 ant ibodies in our Microbiology Department and obtained from adult inpatients a nd outpatients of our Hospital. Serum from all patients and controls was te sted for antibodies to B19 by enzyme-linked immunosorbent assay (ELISA). Ad ditionally, the presence of B19 DNA in serum and in circulating leukocytes was investigated by nested polymerase chain reaction (PCR). Results: Serological evidence of past B19 infection (positive IgG antibodie s without IgM antibodies) was present in 28 (35%) patients with primary SS, None of these patients showed evidence for B19 viremia, and B19 virus DNA was not detected in the circulating leukocytes of IgG-B19(+) patients. Posi tivity for IgM antibodies to B19 was not detected in any patient. When comp ared with patients without evidence of past B19 infection, those with prima ry SS and past B19 infection showed a higher prevalence of cytopenia (57% v 15%; P < .001), and, specifically, of leukopenia (36% v 4%; P < .001). Add itionally, when compared with controls positive for lgG-B19, SS patients wi th these antibodies had a higher prevalence of cytopenia (57% v 13%; P < .0 01), leukopenia (36% v 3%; P < .001) and thrombocytopenia (21% v 0%; P = .0 03). Conclusions: Serological evidence of past B19 infection is associated with the presence of cytopenia in our patients with primary SS. A possible relat ionship between B19 infection and the presence of cytopenia in primary SS m ay occur in some patients immunologically or genetically predisposed. Copyr ight (C) 2000 by W.B. Saunders Company.