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Article ; Online: Parvovirus B19 infection and systemic lupus erythematosus: Activation of an aberrant pathway?

Aslanidis, Spyros / Pyrpasopoulou, Athina / Kontotasios, Kostas / Doumas, Stella / Zamboulis, Chryssanthos

European journal of internal medicine

2008  Volume 19, Issue 5, Page(s) 314–318

Abstract: ... mainly rheumatoid arthritis, vasculitis and systemic lupus erythematosus (SLE). B19 infection ... accurate diagnosis of particular importance and justifying the screening for evidence of parvovirus B19 ... with cases of SLE flares. This review describes basic features of parvovirus B19 structure and pathogenicity ...

Abstract Parvovirus B19 infection has been associated with a variety of rheumatic manifestations/diseases, mainly rheumatoid arthritis, vasculitis and systemic lupus erythematosus (SLE). B19 infection may simulate both clinical and laboratory features of SLE, presenting either as a potential first time diagnosis of SLE or as an exacerbation of previously established disease. The similarities in both clinical and serological features of parvovirus infection and SLE at presentation may hinder the differential diagnosis between these two conditions. Hence, parvovirus B19 infection mimicking SLE usually fulfils <4 ACR criteria for SLE, rarely includes cardiac or renal involvement or presents with haemolytic anaemia, and is usually associated with short-lived, low titers of autoantibodies. Rarely, cases of multisystemic involvement solely attributed to a recent parvovirus B19 infection have been reported, rendering early accurate diagnosis of particular importance and justifying the screening for evidence of parvovirus B19 involvement in newly diagnosed cases of SLE, especially the ones with abrupt onset of symptoms along with cases of SLE flares. This review describes basic features of parvovirus B19 structure and pathogenicity and expands on the parvo-associated auto-immune manifestations particularly in relation to SLE-mimicking or SLE-triggering reported cases. The proposed mechanisms for viral-induced pathologic autoimmunity are discussed with emphasis on emerging data regarding the aberrant expression and localization of autoantigens and their potential implication in alternatively activated immunological cascades.
MeSH term(s) Autoantibodies/immunology ; Diagnosis, Differential ; Humans ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/virology ; Parvoviridae Infections/diagnosis ; Parvoviridae Infections/immunology ; Parvoviridae Infections/virology ; Parvovirus B19, Human/immunology ; Parvovirus B19, Human/ultrastructure
Chemical Substances Autoantibodies
Language English
Publishing date 2008-07
Publishing country Netherlands
Document type Journal Article ; Review
ZDB-ID 1038679-8
ISSN 1879-0828 ; 0953-6205
ISSN (online) 1879-0828
ISSN 0953-6205
DOI 10.1016/j.ejim.2007.09.013
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