{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T12:56:36Z","timestamp":1780059396334,"version":"3.54.0"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018934","name":"Universit\u00e4t Greifswald","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018934","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>\n                    Parvovirus B19 infection is mostly asymptomatic in immunocompetent individuals but may cause severe manifestations when humoral immunity is impaired. Anti-CD20 therapies such as rituximab induce prolonged B-cell depletion and hypogammaglobulinemia, affecting the immune coordination and lowering the threshold for viral neuroinvasion and persistence within the central nervous system (CNS). We present a case of a 61-year-old patient who developed new-onset seizures 9 months after completing rituximab as fourth-line therapy for immune-mediated thrombocytopenia. Brain MRI showed a focal hyperintense lesion in the left peri-insular region with edema. Parvovirus B19 DNA was detected in the cerebrospinal fluid via polymerase chain reaction, while extensive testing for other infectious and autoimmune causes of encephalitis was negative. Immunological work-up demonstrated persistent depletion of CD19\n                    <jats:sup>+<\/jats:sup>\n                    B lymphocytes and severe hypogammaglobulinemia. This case highlights the role of impaired humoral immunity in facilitating viral persistence within the CNS and emphasizes the need to consider parvovirus B19 and other uncommon pathogens as a potential cause of encephalitis in patients with prior anti-CD20 therapy, even months after treatment completion.\n                  <\/jats:p>","DOI":"10.3389\/fimmu.2026.1698621","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T05:20:16Z","timestamp":1776403216000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case report: Parvovirus B19 encephalitis following rituximab therapy in a patient with immune-mediated thrombocytopenia"],"prefix":"10.3389","volume":"17","author":[{"given":"Valerio","family":"Campolo","sequence":"first","affiliation":[{"name":"Department of Neurology, Agaplesion Bethesda Hospital","place":["Wuppertal, Germany"]},{"name":"Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatry University Hospital Zurich","place":["Zurich, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Kitzrow","sequence":"additional","affiliation":[{"name":"Department of Neurology, Agaplesion Bethesda Hospital","place":["Wuppertal, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guglielmo","family":"Lucchese","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, University of Salento","place":["Lecce, Italy"]},{"name":"Department of Neurology, \u201cVito Fazzi\u201d University Hospital","place":["Lecce, Italy"]},{"name":"Department of Neurology, University Medicine Greifswald","place":["Greifswald, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietrich","family":"Sturm","sequence":"additional","affiliation":[{"name":"Department of Neurology, Agaplesion Bethesda Hospital","place":["Wuppertal, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1128\/CMR.15.3.485-505.2002","article-title":"Human parvovirus B19","volume":"15","author":"Heegaard","year":"2002","journal-title":"Clin Microbiol Rev"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019001380","article-title":"American Society of Hematology 2019 guidelines for immune thrombocytopenia","volume":"3","author":"Neunert","year":"2019","journal-title":"Blood Adv"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-017-0612-x","article-title":"Rituximab in B-cell hematologic Malignancies: a review of 20 years of clinical experience","volume":"34","author":"Salles","year":"2017","journal-title":"Adv 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Discov"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s13760-019-01227-y","article-title":"Parvovirus B19 infection in a patient with multiple sclerosis treated with ocrelizumab","volume":"120","author":"Lattanzi","year":"2020","journal-title":"Acta Neurol Belg"}],"container-title":["Frontiers in 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