Jo, Kyo Jin
(Department of Pediatrics, Pusan National University Children's Hospital)
,
Lee, Yeoun Joo
(Department of Pediatrics, Pusan National University Children's Hospital)
,
Park, Kyung Mi
(Department of Pediatrics, Pusan National University Children's Hospital)
,
Yang, Eu Jeen
(Department of Pediatrics, Pusan National University Children's Hospital)
,
Yoo, Sukdong
(Department of Pediatrics, Pusan National University Children's Hospital)
,
Lim, Taek Jin
(Department of Pediatrics, Pusan National University Children's Hospital)
,
Park, Su Eun
(Department of Pediatrics, Pusan National University Children's Hospital)
목적: 인간 파르보바이러스 B19 감염은 무증상에서 생명을 위협하는 합병증에 이르기까지 광범위하고 다양한 증상을 나타낸다. 우리는 파르보바이러스 B19 감염의 지역사회 내 집단발생 시기 동안, 파르보바이러스 B19 감염의 다양한 임상 양상에 대해 조사하였다. 방법: 2017년 12월부터 2019년 4월까지 부산대학교 어린이병원에서 파르보바이러스 B19 면역 글로불린 M (IgM) 또는 중합효소 연쇄 반응(polymerase chain reaction, PCR)에 의해 검출된 파르보바이러스 B19 DNA를 가진 소아의 임상적 특징을 후향적 차트 분석을 통해 알아보았다. 결과: 24명의 어린이가 파르보바이러스 B19 감염으로 진단되었다. 24명의 환자 중 12명(50%)은 레이스 형태 발진이 있었고, 24명의 환자 중 4명(16.7%)은 점상출혈 발진, 24명의 환자 중 2명(8.3%)은 무병소 발열로 진단되었다. 24명 중 6명의 환자(25%)는 골수무형성위기가 발생하였고, 이 중 3명은 이전에 유전 구형적혈구증, 3명은 이전에 급성 림프모구 백혈병으로 진단되었던 환자이다. 결론: 감염홍반 외에도 파르보바이러스 B19 감염의 임상적 특징은 다양한 종류의 발진과 무병소 발열으로 나타날 수 있다. 또한, 혈액학적 증상으로 중성구 감소증, 골수무형성 위기와 같이 발생할 수 있다.
목적: 인간 파르보바이러스 B19 감염은 무증상에서 생명을 위협하는 합병증에 이르기까지 광범위하고 다양한 증상을 나타낸다. 우리는 파르보바이러스 B19 감염의 지역사회 내 집단발생 시기 동안, 파르보바이러스 B19 감염의 다양한 임상 양상에 대해 조사하였다. 방법: 2017년 12월부터 2019년 4월까지 부산대학교 어린이병원에서 파르보바이러스 B19 면역 글로불린 M (IgM) 또는 중합효소 연쇄 반응(polymerase chain reaction, PCR)에 의해 검출된 파르보바이러스 B19 DNA를 가진 소아의 임상적 특징을 후향적 차트 분석을 통해 알아보았다. 결과: 24명의 어린이가 파르보바이러스 B19 감염으로 진단되었다. 24명의 환자 중 12명(50%)은 레이스 형태 발진이 있었고, 24명의 환자 중 4명(16.7%)은 점상출혈 발진, 24명의 환자 중 2명(8.3%)은 무병소 발열로 진단되었다. 24명 중 6명의 환자(25%)는 골수무형성위기가 발생하였고, 이 중 3명은 이전에 유전 구형적혈구증, 3명은 이전에 급성 림프모구 백혈병으로 진단되었던 환자이다. 결론: 감염홍반 외에도 파르보바이러스 B19 감염의 임상적 특징은 다양한 종류의 발진과 무병소 발열으로 나타날 수 있다. 또한, 혈액학적 증상으로 중성구 감소증, 골수무형성 위기와 같이 발생할 수 있다.
Purpose: Human parvovirus B19 infection is widespread and has a heterogeneous clinical spectrum, ranging from asymptomatic infection to potentially life-threatening complications. We investigated the various clinical features of human parvovirus B19 infection during an outbreak of the virus in our c...
Purpose: Human parvovirus B19 infection is widespread and has a heterogeneous clinical spectrum, ranging from asymptomatic infection to potentially life-threatening complications. We investigated the various clinical features of human parvovirus B19 infection during an outbreak of the virus in our community. Methods: A retrospective chart review study was conducted at the Pusan National University Children's Hospital from December 2017 to April 2019. We investigated the clinical features of children with parvovirus B19 immunoglobulin M or parvovirus B19 DNA detected using polymerase chain reaction. Results: A total of 24 children were diagnosed with parvovirus B19 infection. Twelve (50%) had lace form rashes, and four (16.7%) had petechial rashes. Two (8.3%) were diagnosed with fever without a focus. Six (25%) developed aplastic crisis as a complication of infection, of whom three were previously diagnosed with hereditary spherocytosis and three with acute lymphoblastic leukemia. Conclusions: In addition to erythema infectiosum, the parvovirus B19 infection can present clinically with various types of rashes and fever without a focus. Furthermore, hematologic manifestations such as neutropenia and aplastic crisis can occur during infection.
Purpose: Human parvovirus B19 infection is widespread and has a heterogeneous clinical spectrum, ranging from asymptomatic infection to potentially life-threatening complications. We investigated the various clinical features of human parvovirus B19 infection during an outbreak of the virus in our community. Methods: A retrospective chart review study was conducted at the Pusan National University Children's Hospital from December 2017 to April 2019. We investigated the clinical features of children with parvovirus B19 immunoglobulin M or parvovirus B19 DNA detected using polymerase chain reaction. Results: A total of 24 children were diagnosed with parvovirus B19 infection. Twelve (50%) had lace form rashes, and four (16.7%) had petechial rashes. Two (8.3%) were diagnosed with fever without a focus. Six (25%) developed aplastic crisis as a complication of infection, of whom three were previously diagnosed with hereditary spherocytosis and three with acute lymphoblastic leukemia. Conclusions: In addition to erythema infectiosum, the parvovirus B19 infection can present clinically with various types of rashes and fever without a focus. Furthermore, hematologic manifestations such as neutropenia and aplastic crisis can occur during infection.
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문제 정의
From December 2017 to April 2019, the number of patients presenting with symptoms suggesting parvovirus B19 infection, such as erythema infectiosum, or purpuric or petechial rashes, increased in Gyeongsangnam-do area compared to that in the previous eight years. The aim of this study was to investigate the various clinical features in children with confirmed parvovirus B19 infection.
제안 방법
First, this study is retrospective, which has inherent biases. Second, the patients in this study were evaluated for parvovirus B19 IgM or parvovirus B19 PCR by clinical doctors who met the patients in the emergency room or outpatient room. Whether or not parvovirus B19 testing was performed was determined by the doctor who first met the patient.
Data on sex, age, fever, rashes, complete blood count, and liver function tests were collected from medical records. Serologic tests for parvovirus B19 IgM antibodies were performed at GC LabCell (Yongin, Korea) using an enzyme immunoassay (Denka Seiken Co., Tokyo, Japan). Serum tests for detection of parvovirus B19 DNA were performed using PCR (Biometra GmbH, Germany) with 2 primers directed at the VP1 gene.
대상 데이터
A total of 66 patients were tested for parvovirus B19 IgM or parvovirus B19 PCR from December 2017 to April 2019. There were various reasons of suspecting parvovirus B19 infection in these patients, such as a diffuse maculopapular rash evolving to a reticular pattern, petechial rashes, leukopenia, anemia, pancytopenia, elevated liver function test parameters, fetal hydrops, or fever without a focus.
There was no patient with a laboratory-confirmed co-infection, such as bacteremia, respiratory virus infections, Epstein-Barr virus (EBV) infection, or cytomegalovirus (CMV) infection. Among the 24 patients, 11 (45.8%) underwent blood culture, three (12.5%) underwent respiratory virus multiplex PCR (BioFire, Salt Lake City, UT, USA), four (16.7%) underwent EBV IgM testing, and two (8.3%) underwent both CMV IgM and CMV PCR testing.
3%; Table1). Parvovirus B19 IgM was performed in 24 patients and was positive in 22 of these patients. Parvovirus B19 PCR was performed in 16 patients and was positive in all these patients.
All the patients with aplastic crisis recovered after 4 weeks. Two of the 24 patients (8.3%) did not have detectable parvovirus B19 IgM, but had detectable parvovirus B19 DNA in their blood. One of these two patients had ALL, while the other patient was healthy.
성능/효과
The laboratory tests findings of patients with aplastic crisis showed median white blood cell count 2,680 cells/μL (range 2,340 to 11,610), median hemoglobin 7.1 g/dL (range 6.0 to 8.9), and median platelet count 305,000 cells/μL (range 83,000 to 372,000).
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논문에서 추출한 답변
파르보바이러스 B19 감염의 임상적 특징은?
24명 중 6명의 환자(25%)는 골수무형성위기가 발생하였고, 이 중 3명은 이전에 유전 구형적혈구증, 3명은 이전에 급성 림프모구 백혈병으로 진단되었던 환자이다. 결론: 감염홍반 외에도 파르보바이러스 B19 감염의 임상적 특징은 다양한 종류의 발진과 무병소 발열으로 나타날 수 있다. 또한, 혈액학적 증상으로 중성구 감소증, 골수무형성 위기와 같이 발생할 수 있다.
인간 파르보바이러스 B19 감염은 어떤 증상을 나타내는가?
목적: 인간 파르보바이러스 B19 감염은 무증상에서 생명을 위협하는 합병증에 이르기까지 광범위하고 다양한 증상을 나타낸다. 우리는 파르보바이러스 B19 감염의 지역사회 내 집단발생 시기 동안, 파르보바이러스 B19 감염의 다양한 임상 양상에 대해 조사하였다.
지역사회 내 집단발생 시기 동안 인간 파르보바이러스 B19 감염의 임상 양상에 대한 조사 방법은 어떻게 진행되는가?
우리는 파르보바이러스 B19 감염의 지역사회 내 집단발생 시기 동안, 파르보바이러스 B19 감염의 다양한 임상 양상에 대해 조사하였다. 방법: 2017년 12월부터 2019년 4월까지 부산대학교 어린이병원에서 파르보바이러스 B19 면역 글로불린 M (IgM) 또는 중합효소 연쇄 반응(polymerase chain reaction, PCR)에 의해 검출된 파르보바이러스 B19 DNA를 가진 소아의 임상적 특징을 후향적 차트 분석을 통해 알아보았다. 결과: 24명의 어린이가 파르보바이러스 B19 감염으로 진단되었다.
참고문헌 (17)
Aydinoz S, Karademir F, Suleymanoglu S, Ozkaya H, Gocmen I. Parvovirus B19 associated papular-purpuric gloves-and-socks syndrome. Turk J Pediatr 2006;48:351-3.
Chinsky JM, Kalyani RR. Fever and petechial rash associated with parvovirus B19 infection. Clin Pediatr (Phila) 2006;45:275-80.
Conway SP, Cohen BJ, Field AM, Hambling MH. A family outbreak of parvovirus B19 infection with petechial rash in a 7-year-old boy. J Infect 1987;15:110-2.
Edmonson MB, Riedesel EL, Williams GP, DeMuri GP. Generalized petechial rashes in children during a parvovirus B19 outbreak. Pediatrics 2010;125:e787-92.
Song SA, Lee MY, Kim SH, Lee JY, Oh SH, Shin JH, et al. Autoimmune hemolytic anemia after aplastic crisis due to parvovirus B19 infection in a patient with hereditary spherocytosis. Lab Med Online 2012;2:166-9.
Choi HJ, Lee JH, Lee KS. The aplastic crisis of hereditary spherocytosis due to parvovirus B19 infection. Clin Pediatr Hematol Oncol 2006;13:22-31.
Park YJ, Koh DK, Oh JH. Aplastic crisis secondary to parvovirus B19 infection. J Korean Pediatr Soc 2003;46:1139-42.
Sung KW, Chang EJ, Jang WJ, Jeon IS. Parvovirus B19 infection in a child with acute lymphoblastic leukemia during maintenance chemotherapy. Clin Pediatr Hematol Oncol 2012;19:44-8.
Foti C, Bonamonte D, Conserva A, Grandolfo M, Casulli C, Martire B. Erythema infectiosum following generalized petechial eruption induced by human parvovirus B19. New Microbiol 2006;29:45-8.
Shin H, Park S, Lee GW, Koh EH, Kim HY. Parvovirus B19 infection presenting with neutropenia and thrombocytopenia: three case reports. Medicine (Baltimore) 2019;98:e16993.
Lindblom A, Heyman M, Gustafsson I, Norbeck O, Kaldensjo T, Vernby A, et al. Parvovirus B19 infection in children with acute lymphoblastic leukemia is associated with cytopenia resulting in prolonged interruptions of chemotherapy. Clin Infect Dis 2008;46:528-36.
Anderson LJ, Tsou C, Parker RA, Chorba TL, Wulff H, Tattersall P, et al. Detection of antibodies and antigens of human parvovirus B19 by enzyme-linked immunosorbent assay. J Clin Microbiol 1986;24:522-6.
Melegaro A, Jit M, Gay N, Zagheni E, Edmunds WJ. What types of contacts are important for the spread of infections?: using contact survey data to explore European mixing patterns. Epidemics 2011;3:143-51.
Chorba T, Coccia P, Holman RC, Tattersall P, Anderson LJ, Sudman J, et al. The role of parvovirus B19 in aplastic crisis and erythema infectiosum (fifth disease). J Infect Dis 1986;154:383-93.
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