Several cases of glomerulonephritis occurring after infection with human parvovirus B19 (PVB19) have been reported. However, the pathogenesis and clinicopathological features of PVB19-related glomerulonephritis remain elusive. We describe the case of a 34 year-old woman who showed nephrotic syndrome and microscopic hematuria 10 days after PVB19 infection. Blood pressure and renal function were within normal ranges. Laboratory tests showed positive results for anti-PVB19 immunoglobulin (Ig)M antibody and complement 3 (C3) hypocomplementemia. Antibody to streptolysin O (ASO) was slightly elevated, but bacterial cultures yielded no colonies. Light microscopy of renal biopsy was compatible with membranoproliferative glomerulonephritis (MPGN). Immunofluorescence microscopy showed intense staining for C3 and faint staining for IgG on the glomerular capillary wall and paramesangial area. Electron micrography showed subendothelial electron-dense deposits (EDDs), but hump-shaped subepithelial EDDs were not evident. PBV19-DNA was absent from renal tissue. Moreover, glomeruli showed positive staining for nephritis-associated plasmin receptor (NAPlr) and plasmin activity with similar distribution. Around 6 months after PVB19 infection, levels of anti-PVB19 IgM antibody spontaneously tuned negative with an apparent reduction of proteinuria and improvement of hypocomplementemia, although ASO level remained unchanged. This appears to represent the first description of positive glomerular staining for NAPlr in MPGN after PVB19 infection. Based on a review of 27 cases, including our own case, the MPGN lesions could be attributable to PVB19 infection. Clinicopathological features of this case were incompatible with post-streptococcal acute glomerulonephritis. We presume that a PBV19-derived glomerular pathogen that cross-reacts with anti-NAPlr antibody might be involved in the development of PVB19-related MPGN.
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http://dx.doi.org/10.1007/s13730-024-00956-1 | DOI Listing |
CEN Case Rep
December 2024
Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan.
Several cases of glomerulonephritis occurring after infection with human parvovirus B19 (PVB19) have been reported. However, the pathogenesis and clinicopathological features of PVB19-related glomerulonephritis remain elusive. We describe the case of a 34 year-old woman who showed nephrotic syndrome and microscopic hematuria 10 days after PVB19 infection.
View Article and Find Full Text PDFPediatr Infect Dis J
December 2024
Department of Pediatric Infectious Diseases, Katip Çelebi University, İzmir, Turkey.
Human parvovirus B19 typically causes erythema infectiosum, but unusual exanthems and hemorrhagic manifestations, such as purpuric-petechial rashes, have also been reported. PVB19-associated purpuric-petechial eruption (PAPPE) should be recognized as a distinct clinical feature of primary parvovirus B19 infection and considered in the differential diagnosis of patients with febrile purpura. This report aims to highlight several scenarios of B19V-associated petechial and purpuric rashes, which may present to pediatric departments during outbreaks.
View Article and Find Full Text PDFJ Clin Exp Hepatol
September 2024
Department of Biostatistics and Health Informatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
J Med Virol
September 2024
Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
Transpl Immunol
December 2024
School of Medicine, Islamic Azad University, Tehran Medical Branch, Tehran, Iran.
One of the issues during the post-transplant phase is anemia. The increased risk of graft rejection makes evaluating transplant recipients difficult. Parvovirus-B19 (PV-B19) should be considered one of the differential diagnosis of post-transplant anemia (PTA) in renal transplantation recipients.
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