{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T17:09:51Z","timestamp":1789232991200,"version":"build-2803163510"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"JSPS KAKENHI","award":["24\u00a0K18642"],"award-info":[{"award-number":["24\u00a0K18642"]}]},{"name":"TSUCHIYA MEMORIAL MEDICAL FOUNDATION"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>An 84-year-old man with rheumatoid arthritis undergoing treatment with methotrexate presented with fever, general fatigue, and appetite loss. He had a 3-month history of unexplained normocytic anaemia with reticulocytopenia. Bone marrow examination revealed erythroid hypoplasia with giant pro-erythroblasts, leading to a diagnosis of parvovirus B19 infection. In this case, intravenous immunoglobulin therapy improved the patient\u2019s anaemia and systemic symptoms. Six months after the treatment, parvovirus B19 DNA remained detectable using polymerase chain reaction; however, the viral load had markedly decreased, indicating a favourable virological response. Twenty cases of parvovirus B19 infection in older adults (aged \u226565\u00a0years) were identified in the literature. Immunocompromised older patients frequently develop persistent parvovirus B19 infections that require treatment with intravenous immunoglobulin therapy, whereas persistent infections are not observed in immunocompetent older individuals. Therefore, this case suggests that clinicians should be aware of persistent parvovirus B19 infection in older immunosuppressed patients who develop unexplained anaemia with reticulocytopenia. Moreover, intravenous immunoglobulin therapy may be considered as an effective therapeutic option for persistent parvovirus B19 infection in immunocompromised patients.<\/jats:p>","DOI":"10.1093\/mrcr\/rxag057","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:49:31Z","timestamp":1784116171000},"source":"Crossref","is-referenced-by-count":0,"title":["Persistent parvovirus B19 infection in an older patient with rheumatoid arthritis receiving immunosuppressive therapy: A case report and literature review"],"prefix":"10.1093","volume":"10","author":[{"given":"Masako","family":"Oyama","sequence":"first","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0774-0509","authenticated-orcid":false,"given":"Yusuke","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]},{"name":"Department of Rheumatology, JA Hiroshima General Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsumi","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9168-5302","authenticated-orcid":false,"given":"Hiroki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Shigemasa","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohisa","family":"Usagawa","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3568-3430","authenticated-orcid":false,"given":"Michinori","family":"Ishitoku","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0968-9081","authenticated-orcid":false,"given":"Tomohiro","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2474-9943","authenticated-orcid":false,"given":"Shintaro","family":"Hirata","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"2026091212420671000_ref1","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1056\/NEJMra030840","article-title":"Parvovirus B19","volume":"350","author":"Young","year":"2004","journal-title":"N Engl J Med"},{"key":"2026091212420671000_ref2","doi-asserted-by":"crossref","DOI":"10.1128\/microbiolspec.DMIH2-0008-2015","article-title":"Parvovirus B19","volume":"4","author":"Landry","year":"2016","journal-title":"Microbiol Spectr"},{"key":"2026091212420671000_ref3","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1038\/302426a0","article-title":"A human parvovirus-like virus inhibits haematopoietic colony formation in vitro","volume":"302","author":"Mortimer","year":"1983","journal-title":"Nature"},{"key":"2026091212420671000_ref4","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s11916-003-0031-3","article-title":"Cytokines in parvovirus B19 infection as an aid to understanding chronic fatigue syndrome","volume":"7","author":"Kerr","year":"2003","journal-title":"Curr Pain Headache Rep"},{"key":"2026091212420671000_ref5","doi-asserted-by":"crossref","first-page":"e100","DOI":"10.1086\/374666","article-title":"Successful intravenous immunoglobulin therapy in three cases of parvovirus B19-associated chronic fatigue syndrome","volume":"36","author":"Kerr","year":"2003","journal-title":"Clin Infect Dis"},{"key":"2026091212420671000_ref6","doi-asserted-by":"crossref","first-page":"903","DOI":"10.2169\/internalmedicine.42.903","article-title":"Acute parvovirus B19 infection mimicking chronic fatigue syndrome","volume":"42","author":"Matano","year":"2003","journal-title":"Intern Med"},{"key":"2026091212420671000_ref7","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1056\/NEJM198908243210807","article-title":"Pure red-cell aplasia of 10 years' duration due to persistent parvovirus B19 infection and its cure with immunoglobulin therapy","volume":"321","author":"Kurtzman","year":"1989","journal-title":"N Engl J Med"},{"key":"2026091212420671000_ref8","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1002\/jmv.20870","article-title":"Dose-by-dose virological and hematological responses to intravenous immunoglobulin in an immunocompromised patient with persistent parvovirus B19 infection","volume":"79","author":"Tang","year":"2007","journal-title":"J Med Virol"},{"key":"2026091212420671000_ref9","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1093\/cid\/cis1046","article-title":"Intravenous immunoglobulin therapy for pure red cell aplasia related to human parvovirus b19 infection: a retrospective study of 10 patients and review of the literature","volume":"56","author":"Crabol","year":"2013","journal-title":"Clin Infect Dis"},{"key":"2026091212420671000_ref10","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.11150\/kansenshogakuzasshi1970.69.1135","article-title":"Serological diagnosis for human parvovirus B19 infection by an enzyme immunoassay kit with recombinant antigens synthesized in a baculovirus expression system","volume":"69","author":"Yoto","year":"1995","journal-title":"Kansenshogaku Zasshi"},{"key":"2026091212420671000_ref11","first-page":"184","article-title":"Human parvovirus B19 and blood product safety: a tale of twenty years of improvements","volume":"13","author":"Marano","year":"2015","journal-title":"Blood Transfus"},{"key":"2026091212420671000_ref12","doi-asserted-by":"crossref","first-page":"2504","DOI":"10.1182\/blood-2016-05-717140","article-title":"Pure red cell aplasia","volume":"128","author":"Means","year":"2016","journal-title":"Blood"},{"key":"2026091212420671000_ref13","first-page":"493","article-title":"Human parvovirus B19-induced aplastic crisis in an older man with intestinal hemorrhage","volume":"34","author":"Kamoshita","year":"1993","journal-title":"Rinsho Ketsueki"},{"key":"2026091212420671000_ref14","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1093\/rheumatology\/32.2.158","article-title":"Exacerbation of systemic lupus erythematosus during human parvovirus B19 infection","volume":"32","author":"Chassagne","year":"1993","journal-title":"Br J Rheumatol"},{"key":"2026091212420671000_ref15","first-page":"849","article-title":"Lupus syndrome following parvovirus B19 infection","volume":"64","author":"Roblot","year":"1997","journal-title":"Rev Rhum Engl Ed"},{"key":"2026091212420671000_ref16","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.ejim.2007.01.004","article-title":"Parvovirus B19 infection as a cause of cytopenia with a lupus-like presentation in the older: a case report","volume":"18","author":"Federici","year":"2007","journal-title":"Eur J Intern Med"},{"key":"2026091212420671000_ref17","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s15010-007-6313-7","article-title":"Detection of parvovirus B19 and Chlamydophila pneumoniae in a patient with atypical sarcoidosis","volume":"37","author":"Contini","year":"2009","journal-title":"Infection"},{"key":"2026091212420671000_ref18","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1111\/j.1365-2141.2009.07830.x","article-title":"Chronic parvovirus B19 infection leading to red cell aplasia following treatment of Hodgkin lymphoma","volume":"148","author":"Poplar","year":"2010","journal-title":"Br J Hematol"},{"key":"2026091212420671000_ref19","doi-asserted-by":"crossref","first-page":"24","DOI":"10.3109\/s10165-010-0338-y","article-title":"Clinical findings in parvovirus B19 infection in 30 adult patients in Kyoto","volume":"21","author":"Oiwa","year":"2011","journal-title":"Mod Rheumatol"},{"key":"2026091212420671000_ref20","doi-asserted-by":"crossref","first-page":"2615","DOI":"10.1007\/s10067-016-3379-6","article-title":"Agranulocytosis under biotherapy in rheumatoid arthritis: three case hypothesis of parvovirus B19 involvement in agranulocytosis observed under tocilizumab and rituximab for the treatment of rheumatoid arthritis","volume":"35","author":"Giraud","year":"2016","journal-title":"Clin Rheumatol"},{"key":"2026091212420671000_ref21","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1182\/blood-2017-05-785691","article-title":"Red cheeks to red cell aplasia: parvovirus B19 in a heart transplant patient","volume":"130","author":"Sadigh","year":"2017","journal-title":"Blood"},{"key":"2026091212420671000_ref22","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.nefro.2016.08.005","article-title":"Anaemia and fever in kidney transplant: the role of human parvovirus B19","volume":"37","author":"Parodis L\u00f3pez","year":"2017","journal-title":"Nefrologia"},{"key":"2026091212420671000_ref23","doi-asserted-by":"crossref","first-page":"2361","DOI":"10.1056\/NEJMicm1807156","article-title":"Parvovirus B19 infection","volume":"379","author":"Mende","year":"2018","journal-title":"N Engl J Med"},{"key":"2026091212420671000_ref24","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.jbspin.2016.12.013","article-title":"Non-HCV-related cryoglobulinemic vasculitis","volume":"85","author":"Lazzerini","year":"2018","journal-title":"Joint Bone Spine"},{"key":"2026091212420671000_ref25","doi-asserted-by":"crossref","first-page":"e17040","DOI":"10.1097\/MD.0000000000017040","article-title":"Syphilis and parvovirus B19 co-infection imitating a lupus nephropathy: a case report","volume":"98","author":"Jaunin","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"2026091212420671000_ref26","first-page":"e12095","article-title":"A rare presentation of parvovirus-induced pure red cell aplasia in an older male with inclusion body myositis","volume":"12","author":"Mandal","year":"2020","journal-title":"Cureus"},{"key":"2026091212420671000_ref27","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1002\/ajh.25761","article-title":"Giant proerythroblasts in pure red cell aplasia due to parvovirus B19 infection in a patient with rheumatoid arthritis","volume":"95","author":"Harper","year":"2020","journal-title":"Am J Hematol"},{"key":"2026091212420671000_ref28","doi-asserted-by":"crossref","first-page":"e936445","DOI":"10.12659\/AJCR.936445","article-title":"Isolated anemia in a 69-year-old man with HIV-1: features of pure red cell aplasia mediated by chronic parvovirus-B19 infection","volume":"23","author":"Wylde","year":"2022","journal-title":"Am J Case Rep"},{"key":"2026091212420671000_ref29","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1186\/s12879-022-07213-9","article-title":"Adult acute respiratory distress syndrome due to human parvovirus B19 infection after cardiac surgery: a case report","volume":"22","author":"Ma","year":"2022","journal-title":"BMC Infect Dis"},{"key":"2026091212420671000_ref30","doi-asserted-by":"crossref","first-page":"e939696","DOI":"10.12659\/AJCR.939696","article-title":"Parvovirus B19 infection: a vasculitis masquerade in an older patient","volume":"24","author":"Suzuki","year":"2023","journal-title":"Am J Case Rep"},{"key":"2026091212420671000_ref31","first-page":"e43925","article-title":"Hoagland's sign as a manifestation of parvovirus B19 infection","volume":"15","author":"Tanimura","year":"2023","journal-title":"Cureus"},{"key":"2026091212420671000_ref32","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1080\/1750743X.2025.2549675","article-title":"Pure red cell aplasia due to parvovirus B19 infection and atezolizumab: case report and literature review","volume":"17","author":"Pallotta","year":"2025","journal-title":"Immunotherapy"},{"key":"2026091212420671000_ref33","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S0046-8177(00)80215-4","article-title":"Unusual bone marrow manifestations of parvovirus B19 infection in immunocompromised patients","volume":"31","author":"Crook","year":"2000","journal-title":"Hum Pathol"},{"key":"2026091212420671000_ref34","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3390\/biom6010015","article-title":"The production processes and biological effects of intravenous immunoglobulin","volume":"6","author":"Barahona Afonso","year":"2016","journal-title":"Biomolecules"}],"container-title":["Modern Rheumatology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/mrcr\/advance-article-pdf\/doi\/10.1093\/mrcr\/rxag057\/69159881\/rxag057.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mrcr\/article-pdf\/10\/2\/rxag057\/69159881\/rxag057.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mrcr\/article-pdf\/10\/2\/rxag057\/69159881\/rxag057.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:42:17Z","timestamp":1789231337000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mrcr\/article\/doi\/10.1093\/mrcr\/rxag057\/8736495"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":34,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,6,29]]}},"URL":"https:\/\/doi.org\/10.1093\/mrcr\/rxag057","relation":{},"ISSN":["2472-5625"],"issn-type":[{"value":"2472-5625","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026]]},"published":{"date-parts":[[2026]]},"article-number":"rxag057"}}