Abstract:
RATIONALE:Parvovirus B19 has been linked to polyarteritis nodosa (PAN), but there is some controversy about its pathogenesis regarding whether it is triggered by the immune complex or by the activated immune cells that phagocytose viruses. PATIENT CONCERNS:A 38-year-old woman was admitted with fever and bicytopenia. She also complained of a painful palpable nodule in the left forearm. DIAGNOSIS:Her bone marrow aspirate revealed erythroblasts in abnormal megaloblastic changes, some of which presented with pseudopods, and parvovirus B19 was positive in a PCR analysis of her blood, which was compatible with parvovirus B19-induced hemophagocytic syndrome. Skin excisional biopsy of the nodule on the left forearm revealed a heavy inflammatory cell infiltrate throughout whole layers of a medium-sized vessel, the characteristic feature of PAN. PCR analysis of the vasculitis tissue showed a positive result for parvovirus B19. INTERVENTIONS:Her symptoms spontaneously resolved with supportive care. OUTCOMES:She underwent regular follow-up without recurrence of vasculitis-associated symptoms. LESSONS:This case highlights the presence of parvovirus B19 DNA in vasculitis tissues, which can support the role of cellular immune response in the pathogenesis of parvovirus-associated PAN.
journal_name
Medicine (Baltimore)journal_title
Medicineauthors
Jeong JY,Park JY,Ham JY,Kwon KT,Han Sdoi
10.1097/MD.0000000000022079subject
Has Abstractpub_date
2020-09-04 00:00:00pages
e22079issue
36eissn
0025-7974issn
1536-5964pii
00005792-202009040-00092journal_volume
99pub_type
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