{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:49:14Z","timestamp":1791568154891,"version":"4.3.4"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T00:00:00Z","timestamp":1725580800000},"content-version":"vor","delay-in-days":249,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Parvovirus B19 most frequently causes epidemics of erythema infectiosum in children but also affects adults often leading to rheumatologic manifestations. While the serum profile allows the diagnosis, manifestations may mimic autoimmune conditions. The aim was to evaluate the proportion of patients with acute Parvovirus B19 infection fulfilling classification criteria for rheumatic diseases (RA and SLE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated the clinical and serological features of 54 patients diagnosed with acute Parvovirus B19 infection seeking rheumatological attention between March and June 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The majority of patients were females (78%), with a mean (s.d.) age of 45 (13) years and 54% could not recall any known exposure. Fifty-one\/54 (94%) had arthralgia, 27 (50%) arthritis (oligoarthritis in 67% of them), 24 (44%) fever, 19 (35%) skin rash and 7 (13%) purpura. Symptoms resolution generally occurred within 6\u2009weeks. Complement levels were low in 14\/33 (42%) tested patients, while the presence of serum ANA, anti-dsDNA, anti-phospholipids and rheumatoid factor was detected in 21\/38 (55%), 10\/26 (38%), 6\/12 (50%) and 5\/37 (13%) patients, respectively. Classification criteria for SLE were fulfilled in 93% of ANA-positive patients and RA criteria in 38% of patients with arthritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Parvovirus B19 infection manifestations may vary and nearly all patients with positive serum ANA fulfil the classification criteria for SLE. The risk of misclassification in patients with viral infection should not be overlooked.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/rap\/rkae105","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T20:34:40Z","timestamp":1725568480000},"source":"Crossref","is-referenced-by-count":12,"title":["High risk of misclassification of acute Parvovirus B19 infection into a systemic rheumatic disease"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4122-5057","authenticated-orcid":false,"given":"Bernardo","family":"D\u2019Onofrio","sequence":"first","affiliation":[{"name":"Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital , Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Virelli","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital , Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Pedrollo","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital , Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Caprioli","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital , Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Riva","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital , Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Renna","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital , Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Tonutti","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital , Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University , Pieve Emanuele, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"Luciano","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital , Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University , Pieve Emanuele, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Ceribelli","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital , Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University , Pieve Emanuele, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Gremese","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital , Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University , Pieve Emanuele, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3196-1336","authenticated-orcid":false,"given":"Maria","family":"De Santis","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital , Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University , Pieve Emanuele, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0323-0376","authenticated-orcid":false,"given":"Carlo","family":"Selmi","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital , Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University , Pieve Emanuele, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,9,6]]},"reference":[{"key":"2024091107111429100_rkae105-B1","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.autrev.2008.07.005","article-title":"Human parvovirus B19 infection and autoimmunity","volume":"8","author":"Lunardi","year":"2008","journal-title":"Autoimmun Rev"},{"key":"2024091107111429100_rkae105-B2","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.cca.2007.03.014","article-title":"Induction of antiphospholipid antibodies and antiphospholipid syndrome-like autoimmunity in naive mice with antibody against human parvovirus B19 VP1 unique region protein","volume":"382","author":"Tzang","year":"2007","journal-title":"Clin Chim Acta"},{"key":"2024091107111429100_rkae105-B3","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1007\/s12016-023-08962-4","article-title":"Shared pathogenicity features and sequences between EBV, SARS-CoV-2, and HLA Class I molecule-binding motifs with a potential role in autoimmunity","volume":"65","author":"Adiguzel","year":"2023","journal-title":"Clin Rev Allergy Immunol"},{"key":"2024091107111429100_rkae105-B4","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1093\/rheumatology\/kem132","article-title":"Hepatitis C-associated mixed cryoglobulinaemia: a crossroad between autoimmunity and lymphoproliferation","volume":"46","author":"Saadoun","year":"2007","journal-title":"Rheumatology (Oxford)"},{"key":"2024091107111429100_rkae105-B5","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/QCO.0b013e3283210006","article-title":"Autoimmunity and HIV","volume":"22","author":"Stratton","year":"2009","journal-title":"Curr Opin Infect Dis"},{"key":"2024091107111429100_rkae105-B6","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1002\/art.39027","article-title":"Chikungunya viral arthritis in the United States: a mimic of seronegative rheumatoid arthritis","volume":"67","author":"Miner","year":"2015","journal-title":"Arthritis Rheumatol (Hoboken, NJ)"},{"key":"2024091107111429100_rkae105-B7","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1001\/archinte.1989.00390050111022","article-title":"Clinical manifestations of human parvovirus B19 in adults","volume":"149","author":"Woolf","year":"1989","journal-title":"Arch Intern Med"},{"key":"2024091107111429100_rkae105-B8","doi-asserted-by":"crossref","first-page":"295","DOI":"10.2169\/internalmedicine.41.295","article-title":"A clinical study of adult human parvovirus B19 infection","volume":"41","author":"Hayakawa","year":"2002","journal-title":"Intern Med"},{"key":"2024091107111429100_rkae105-B9","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.2169\/internalmedicine.46.0366","article-title":"Symptoms associated with parvovirus B19 infection in adults: a pilot study","volume":"46","author":"Waza","year":"2007","journal-title":"Intern Med"},{"key":"2024091107111429100_rkae105-B10","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1093\/infdis\/154.3.383","article-title":"The role of parvovirus B19 in aplastic crisis and erythema infectiosum (fifth disease)","volume":"154","author":"Chorba","year":"1986","journal-title":"J Infect Dis"},{"key":"2024091107111429100_rkae105-B11","doi-asserted-by":"crossref","first-page":"S47","DOI":"10.2215\/CJN.01060307","article-title":"Parvovirus B19 and the kidney","volume":"2","author":"Waldman","year":"2007","journal-title":"Clin J Am Soc Nephrol"},{"key":"2024091107111429100_rkae105-B12","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1097\/00006454-198708000-00003","article-title":"Role of parvovirus B19 in human disease","volume":"6","author":"Anderson","year":"1987","journal-title":"Pediatr Infect Dis J"},{"key":"2024091107111429100_rkae105-B13","first-page":"2444","article-title":"Parvovirus arthropathy outbreak in southwestern United States","volume":"27","author":"Scroggie","year":"2000","journal-title":"J Rheumatol"},{"key":"2024091107111429100_rkae105-B14","doi-asserted-by":"crossref","first-page":"244","DOI":"10.18683\/germs.2020.1211","article-title":"Parvovirus B19 infection mimicking systemic lupus erythematosus, successfully treated with intravenous immune globulin","volume":"10","author":"\u00d6zl\u00fc","year":"2020","journal-title":"Germs"},{"key":"2024091107111429100_rkae105-B15","doi-asserted-by":"crossref","first-page":"45","DOI":"10.4078\/jrd.2021.28.1.45","article-title":"Transient systemic lupus erythematosus-like syndrome associated with parvovirus b19 infection: a case report","volume":"28","author":"Kim","year":"2021","journal-title":"J Rheum Dis"},{"key":"2024091107111429100_rkae105-B16","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.jbspin.2016.12.013","article-title":"Non-HCV-related cryoglobulinemic vasculitis and parvovirus-B19 infection","volume":"85","author":"Lazzerini","year":"2018","journal-title":"Jt bone spine"},{"key":"2024091107111429100_rkae105-B17","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.4103\/jfmpc.jfmpc_25_19","article-title":"Acute parvovirus B19 infection presenting as rheumatoid arthritis mimic","volume":"8","author":"Alexander","year":"2019","journal-title":"J Fam Med Prim care"},{"key":"2024091107111429100_rkae105-B18","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1097\/RHU.0b013e31823abf1a","article-title":"Parvovirus B19-associated arthritis: report on a community outbreak","volume":"17","author":"Tello-Winniczuk","year":"2011","journal-title":"J Clin Rheumatol"},{"key":"2024091107111429100_rkae105-B19","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1136\/jclinpath-2015-203455","article-title":"The role of parvovirus B19 in the pathogenesis of autoimmunity and autoimmune disease","volume":"69","author":"Kerr","year":"2016","journal-title":"J Clin Pathol"},{"key":"2024091107111429100_rkae105-B20","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1002\/art.27584","article-title":"2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Arthritis Rheum"},{"key":"2024091107111429100_rkae105-B21","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1002\/art.40930","article-title":"2019 European league against Rheumatism\/American College of Rheumatology classification criteria for systemic lupus erythematosus","volume":"71","author":"Aringer","year":"2019","journal-title":"Arthritis Rheumatol (Hoboken, NJ)"},{"key":"2024091107111429100_rkae105-B22","article-title":"Control EC for DP and risks posed by reported increased circulation of human parvovirus B19 in the EU\/EEA epidemiological situation","year":"2024","journal-title":"Eur Cent Dis Prev Control"},{"key":"2024091107111429100_rkae105-B23","doi-asserted-by":"crossref","first-page":"2400339","DOI":"10.2807\/1560-7917.ES.2024.29.25.2400339","article-title":"An unusual outbreak of parvovirus B19 infections, France, 2023 to 2024","volume":"29","author":"d\u2019Humi\u00e8res","year":"2024","journal-title":"Euro Surveill"},{"key":"2024091107111429100_rkae105-B24","doi-asserted-by":"crossref","first-page":"e475","DOI":"10.1016\/S1473-3099(24)00373-6","article-title":"Extreme upsurge of parvovirus B19 resulting in severe fetal morbidity and mortality","volume":"24","author":"Russcher","year":"2024","journal-title":"Lancet Infect Dis"},{"key":"2024091107111429100_rkae105-B25","doi-asserted-by":"crossref","first-page":"9630","DOI":"10.1038\/s41598-024-59582-7","article-title":"Changing epidemiology of parvovirus B19 in the Netherlands since 1990, including its re-emergence after the COVID-19 pandemic","volume":"14","author":"Russcher","year":"2024","journal-title":"Sci Rep"},{"key":"2024091107111429100_rkae105-B26","doi-asserted-by":"crossref","first-page":"e0025321","DOI":"10.1128\/Spectrum.00253-21","article-title":"Lower incidence of Parvovirus-B19 infections in Dutch blood donors during SARS-CoV-2 pandemic","volume":"9","author":"Molenaar-de Backer","year":"2021","journal-title":"Microbiol Spectr"},{"key":"2024091107111429100_rkae105-B27","doi-asserted-by":"crossref","first-page":"2100186","DOI":"10.2807\/1560-7917.ES.2021.26.29.2100186","article-title":"Transmission of paediatric respiratory syncytial virus and influenza in the wake of the COVID-19 pandemic","volume":"26","author":"Williams","year":"2021","journal-title":"Euro Surveill"},{"key":"2024091107111429100_rkae105-B28","doi-asserted-by":"crossref","first-page":"9525","DOI":"10.3390\/ijerph18189525","article-title":"Circulation of respiratory viruses in hospitalized adults before and during the COVID-19 pandemic in Brescia, Italy: a retrospective study","volume":"18","author":"De Francesco","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2024091107111429100_rkae105-B29","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1080\/1744666X.2023.2157814","article-title":"Inducibility or predestination? Queries and concepts around drug-free remission in rheumatoid arthritis","volume":"19","author":"D\u2019Onofrio","year":"2023","journal-title":"Expert Rev Clin Immunol"},{"key":"2024091107111429100_rkae105-B30","doi-asserted-by":"crossref","first-page":"e743","DOI":"10.1016\/S2665-9913(23)00242-4","article-title":"Autoantibody-negative rheumatoid arthritis: still a challenge for the rheumatologist","volume":"5","author":"Bugatti","year":"2023","journal-title":"Lancet Rheumatol"},{"key":"2024091107111429100_rkae105-B31","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1136\/annrheumdis-2022-222264","article-title":"Progressive increase in time to referral and persistently severe clinical presentation over the years in autoantibody-negative patients with rheumatoid arthritis in the setting of an early arthritis clinic","volume":"81","author":"De Stefano","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"2024091107111429100_rkae105-B32","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1080\/24725625.2020.1832754","article-title":"Refractory liver dysfunction was remarkably improved with chelating agents of Wilson\u2019s disease, in a patient with systemic lupus erythematosus-like syndrome after a Parvovirus B19 infection","volume":"5","author":"Nameki","year":"2021","journal-title":"Mod Rheumatol Case Rep"},{"key":"2024091107111429100_rkae105-B33","doi-asserted-by":"crossref","first-page":"79","DOI":"10.3109\/03009742.2011.617315","article-title":"Severe glomerulonephritis and encephalopathy associated with parvovirus B19 infection mimicking systemic lupus erythematosus","volume":"41","author":"Cugler","year":"2012","journal-title":"Scand J Rheumatol"},{"key":"2024091107111429100_rkae105-B34","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s10156-008-0636-X","article-title":"Intravenous immunoglobulin therapy for severe arthritis associated with human Parvovirus B19 infection","volume":"14","author":"Ogawa","year":"2008","journal-title":"J Infect Chemother"},{"key":"2024091107111429100_rkae105-B35","first-page":"169","article-title":"The prevalence and persistence of human Parvovirus B19 infection in thalassemic patients","volume":"25","author":"Siritantikorn","year":"2007","journal-title":"Asian Pacific J allergy Immunol"},{"key":"2024091107111429100_rkae105-B36","doi-asserted-by":"crossref","first-page":"91","DOI":"10.21500\/20112084.648","article-title":"Affective control and life satisfaction in thalassemics","volume":"8","author":"Mento","year":"2015","journal-title":"Int J Psychol Res"}],"container-title":["Rheumatology Advances in Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/rheumap\/advance-article-pdf\/doi\/10.1093\/rap\/rkae105\/59035152\/rkae105.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/rheumap\/article-pdf\/8\/3\/rkae105\/59080624\/rkae105.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/rheumap\/article-pdf\/8\/3\/rkae105\/59080624\/rkae105.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T03:26:35Z","timestamp":1726025195000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/rheumap\/article\/doi\/10.1093\/rap\/rkae105\/7750413"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":36,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,6,7]]}},"URL":"https:\/\/doi.org\/10.1093\/rap\/rkae105","relation":{},"ISSN":["2514-1775"],"issn-type":[{"value":"2514-1775","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024]]},"published":{"date-parts":[[2024]]},"article-number":"rkae105"}}