{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:26:19Z","timestamp":1761895579792,"version":"3.40.5"},"reference-count":24,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,12,1]]},"abstract":"<jats:p>Parvovirus B19 infection in healthy hosts is self-limited, but persistent infection has been described in patients with cellular immune defects. A 6-year-old boy presented with a 6-month history of weight loss and malaise and a 1-month history of fever and polyarticular arthritis. Parvovirus DNA was detected in plasma at 10\u2009300 copies\/mL. Levels of immunoglobulin (Ig)G, IgA, IgM, IgG-1, and IgG-2 were low, and antibody responses to vaccine antigens were impaired. HIV antibody and DNA polymerase chain reaction were negative, and the patient had normal immunophenotype, mitogen stimulation response, CD40 ligand and inducible costimulator expression, transmembrane activator and CAML interactor sequencing, genomic analysis, and fluorescent in situ hybridization for deletions at 22q11.2. Common variable immunodeficiency was diagnosed and replacement therapy with immune globulin intravenous was initiated. The parvovirus DNA level declined by half over 3 months and was undetectable at 15 months. Constitutional symptoms improved but arthritis persisted and eosinophilic fasciitis eventually developed. This case demonstrates that persistent parvovirus infection may be a presenting feature of humoral immune deficiency and can mimic juvenile rheumatoid arthritis. The infection may respond to immune globulin intravenous therapy.<\/jats:p>","DOI":"10.1542\/peds.2011-2556","type":"journal-article","created":{"date-parts":[[2012,11,6]],"date-time":"2012-11-06T04:18:14Z","timestamp":1352175494000},"page":"e1711-e1715","source":"Crossref","is-referenced-by-count":14,"title":["Common Variable Immunodeficiency Presenting With Persistent Parvovirus B19 Infection"],"prefix":"10.1542","volume":"130","author":[{"given":"Sarah T.M.","family":"Adams","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kara M.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen M.","family":"Cost","sequence":"additional","affiliation":[{"name":"Clinical Immunology Laboratory, Kosair Children\u2019s Hospital, Louisville, Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary S.","family":"Marshall","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2012,12,1]]},"reference":[{"issue":"1","key":"2021120823564231300_B1","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1146\/annurev.med.48.1.59","article-title":"Parvovirus B19 in human disease.","volume":"48","author":"Brown","year":"1997","journal-title":"Annu Rev Med"},{"issue":"1","key":"2021120823564231300_B2","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1086\/517264","article-title":"Clinical relevance of parvovirus B19 as a cause of anemia in patients with human immunodeficiency virus infection.","volume":"176","author":"Abkowitz","year":"1997","journal-title":"J Infect Dis"},{"issue":"3","key":"2021120823564231300_B3","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S1386-6532(02)00104-X","article-title":"B19 virus infection in renal transplant recipients.","volume":"26","author":"Cavallo","year":"2003","journal-title":"J Clin Virol"},{"issue":"8","key":"2021120823564231300_B4","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1056\/NEJM198908243210807","article-title":"Pure red-cell aplasia of 10 years\u2019 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"},{"issue":"6","key":"2021120823564231300_B5","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"},{"issue":"4","key":"2021120823564231300_B6","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1172\/JCI114274","article-title":"Immune response to B19 parvovirus and an antibody defect in persistent viral infection.","volume":"84","author":"Kurtzman","year":"1989","journal-title":"J Clin Invest"},{"issue":"3","key":"2021120823564231300_B7","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1002\/(SICI)1096-8652(199903)60:3<222::AID-AJH9>3.0.CO;2-K","article-title":"Successful treatment of persistent erythroid aplasia caused by parvovirus B19 infection in a patient with common variable immunodeficiency with low-dose immunoglobulin.","volume":"60","author":"Chuhjo","year":"1999","journal-title":"Am J Hematol"},{"issue":"1","key":"2021120823564231300_B8","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1111\/j.1537-2995.2007.01503.x","article-title":"Neutralization of human parvovirus B19 by plasma and intravenous immunoglobulins.","volume":"48","author":"Modrof","year":"2008","journal-title":"Transfusion"},{"issue":"5","key":"2021120823564231300_B9","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"},{"issue":"3","key":"2021120823564231300_B10","first-page":"187","article-title":"Neurological impairment and arthritis in an immunocompetent child with human parvovirus B19 chronic infection.","volume":"18","author":"Bozzola","year":"2010","journal-title":"Infez Med"},{"issue":"5","key":"2021120823564231300_B11","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s11882-009-0051-0","article-title":"Autoimmunity in common variable immunodeficiency.","volume":"9","author":"Agarwal","year":"2009","journal-title":"Curr Allergy Asthma Rep"},{"issue":"2","key":"2021120823564231300_B12","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.autrev.2005.10.002","article-title":"Inflammatory and autoimmune complications of common variable immune deficiency.","volume":"5","author":"Knight","year":"2006","journal-title":"Autoimmun Rev"},{"issue":"6","key":"2021120823564231300_B13","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/S0022-3476(86)80927-1","article-title":"Childhood common variable immunodeficiency with autoimmune disease.","volume":"108","author":"Conley","year":"1986","journal-title":"J Pediatr"},{"issue":"4","key":"2021120823564231300_B14","first-page":"367","article-title":"Arthritis in hypogammaglobulinemia.","volume":"35","author":"Salaria","year":"1998","journal-title":"Indian Pediatr"},{"issue":"3","key":"2021120823564231300_B15","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1097\/00005792-198505000-00001","article-title":"X-linked agammaglobulinemia: an analysis of 96 patients.","volume":"64","author":"Lederman","year":"1985","journal-title":"Medicine (Baltimore)"},{"issue":"9","key":"2021120823564231300_B16","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1002\/art.1780330901","article-title":"Rheumatologic manifestations of human parvovirus B19 infection in adults. Initial two-year clinical experience.","volume":"33","author":"Naides","year":"1990","journal-title":"Arthritis Rheum"},{"issue":"2","key":"2021120823564231300_B17","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/S0022-3476(06)80111-3","article-title":"Human parvovirus B19-associated arthritis in children.","volume":"122","author":"Nocton","year":"1993","journal-title":"J Pediatr"},{"issue":"6","key":"2021120823564231300_B18","first-page":"1336","article-title":"Parvovirus B19 may have a role in the pathogenesis of juvenile idiopathic arthritis.","volume":"34","author":"Gonzalez","year":"2007","journal-title":"J Rheumatol"},{"issue":"6","key":"2021120823564231300_B19","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1002\/art.10979","article-title":"Frequent infection with a viral pathogen, parvovirus B19, in rheumatic diseases of childhood.","volume":"48","author":"Lehmann","year":"2003","journal-title":"Arthritis Rheum"},{"issue":"5","key":"2021120823564231300_B20","doi-asserted-by":"crossref","first-page":"S72","DOI":"10.1016\/j.jaad.2007.05.014","article-title":"Eosinophilic fasciitis in a female child.","volume":"58","author":"Ortega-Loayza","year":"2008","journal-title":"J Am Acad Dermatol"},{"issue":"6","key":"2021120823564231300_B21","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1097\/00002281-199711000-00013","article-title":"Eosinophilia-myalgia syndrome, eosinophilic fasciitis, and related fibrosing disorders.","volume":"9","author":"Varga","year":"1997","journal-title":"Curr Opin Rheumatol"},{"issue":"3","key":"2021120823564231300_B22","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1542\/peds.78.3.512","article-title":"Eosinophilic fasciitis presenting as inflammatory polyarthritis.","volume":"78","author":"Olson","year":"1986","journal-title":"Pediatrics"},{"issue":"1","key":"2021120823564231300_B23","first-page":"73","article-title":"Common variable immunodeficiency and eosinophilic fasciitis.","volume":"12","author":"Di Gioacchino","year":"2002","journal-title":"Eur J Dermatol"},{"issue":"9","key":"2021120823564231300_B24","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1136\/ard.50.9.647","article-title":"Childhood eosinophilic fasciitis presenting as inflammatory polyarthritis and associated with selective IgA deficiency.","volume":"50","author":"Ching","year":"1991","journal-title":"Ann Rheum Dis"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/130\/6\/e1711\/897420\/peds_2011-2556.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/130\/6\/e1711\/897420\/peds_2011-2556.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T03:13:26Z","timestamp":1714533206000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/130\/6\/e1711\/30320\/Common-Variable-Immunodeficiency-Presenting-With"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,12,1]]},"references-count":24,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2012,12,1]]},"published-print":{"date-parts":[[2012,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2011-2556","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"subject":[],"published":{"date-parts":[[2012,12,1]]}}}