Parvovirus B19 Seropositivity and Its Laboratory and Clinical Effects in PICU Admitted Children at Mofid Children Hospital

Document Type: Original article


1 Pediatric Infections Research Center, Research Institute for Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Mofid Children Hospital, Shahid Beheshti University of Medical Sciences Tehran, Iran

3 Alborzi Clinical Microbiology Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran


Background: Acute parvovirus infection may cause different complications and comorbidity in Pediatric Intensive Care Unit (PICU) patients. This study was conducted to investigate the effect of parvovirus infection on death, Hb, WBC count, and liver function tests in patients admitted to Mofid Children Hospital PICU from September 2015 to September 2016.
Methods: 66 children admitted to Mofid Children Hospital PICU were selected. Data on age, sex, underlying disease, anti-parvovirus IgG and IgM antibody, death, Hb, WBC count, AST, and ALT were gathered by questionnaire and data analysis was performed by the SPSS 21.
Results: Age range of children was 1-156 [Mean: 36.5(±41.3 SD)] months. Underlying diseases were gastrointestinal disease (13 cases), respiratory tract illnesses (14 cases), urinary tract diseases (6 cases), nervous system diseases (3 cases), hematological and oncological diseases (7 cases) and other diseases (3 cases). Quantitative results on IgG and IgM were analyzed. IgG and IgM were not significantly associated with Hb and WBC count. ALT over 12.5 IU was more significant in IgM positive cases and AST over 67 IU in IgG positive cases. IgM positivity was significantly associated with death (p<0.05).
Conclusion: Parvovirus serologic antibody can be an important measure in PICU patients because it can be associated with anemia, neutropenia, and LFT tests.


1. Brodlien K, Tolfvenstam T, Norbeck O. Clinical aspects of parvovirus B19 infection. J Intern Med 2006;260(4):285-304.
2. Lindblom A,  Heyman M, Gustafsson I,  Norbeck O,  KaldensjöÅsa T, Vernby A, et al. Parvovirus B19 infection in children with acute lymphoblastic leukemia is associated with cytopenia resulting in prolonged interruptions of chemotherapy. Clinical Infectious Diseases 2008;46(4):528-36.
3. Hillingsø JG, Jensen IP, Tom-Petersen L. [Parvovirus B19 as a cause of acute liver symptoms in adults]. Ugeskr Laeger 1998;160(44):6355-6. Danish.  
4. Bihari C, Rastogi A, Saxena P, Raggegowda D, Chowdhury A, Gupta N, et al.  Parvovirus B19 associated hepatitis. Hepat Res Treat 2013;2013:472027.
5. Sun L, Zhang JC. Acute fulminant hepatitis with bone marrow failure in an adult due to parvovirus B19 infection. Hepatology 2012;55(1):329-30.
6. Liu CC, Huang YF, Nong BR, Hsieh KS, Cheng HH, Liu YC. Possible clinical manifestations of parvovirus B19 infection in critically ill patients.  J Med Sci 2002;22(6):297-304.
7. Cherry JD, Schulte DJ. Human Parvovirus B19. In: Feigin RD, Cherry JD, Demmler-Harrison GJ, Kaplan SL, eds. Feigin & Cherry’s Textbook of Pediatric Infectious Diseases. 6th ed. Vol. 2. Philadelphia, PA: Saunders Elsevier; 2014. p.1841-1857.
8. Naciute M, Mieliauskaite D,  Rugiene Rita,  Nikitenkiene R,  Jancoriene L,  Mauricas M,  et al.  Frequency and significance of parvovirus B19 infection in patients with rheumatoid arthritis. J Gen Virol 2016;97(12):3302-12.
9. Abdellah Saad A, Beshlawi I, Al-Rawas AH, Zachariah M, Fawzy Nazir H, Wali Y. Human parvovirus B19 in children with sickle cell disease; poking the spleen. Oman Med J 2017 Sep; 32(5):425-28.
10. Osaki M , Matsubara K, Iwasaki T, Kurata T, Nigami H, Harigaya H, et al. Severe aplastic anemia associated with human parvovirus B19 infection in a patient without underlying disease. Ann Hematol 1999 Feb;78(2):83-6.
11. Sequeira J, Calado A, Dias M, Manita M. Parvovirus B19 infection associated with hemolytic anemia and cranial polyneuropathy. J Neurovirol 2017 Oct;23(5):786-8.
12. Puigví L, Baumann T, Fernández S, Castro P, Pereira A, Merino A. Massive erythrophagocytosis by peripheral monocytes and neutrophils in parvovirus-B19 autoimmune hemolytic anemia. Ann Hematol 2017;96(5):881-2.
13. Tizeba YA, Mirambo MM, Kayange N, Mhada T, Ambrose EE, Smart LR,  et al. Parvovirus B19 is associated with a significant decrease in hemoglobin level among children 14. Durst R, Goldschmidt N, Ben Yehuda A. Parvovirus B19 infection associated with myelosuppression and cutaneous polyarteritis nodosa. Rheumatology 2002;41(10):1210-12.
15. Wiersbitzky S , Schwarz TF, Ladstätter L, Bruns R, Abel E, Deinhardt F, et al. [Blood picture findings in children with parvovirus B19 infections (fifth disease/erythema infectiosum)]. Kinderarztl Prax 1991 Oct; 59(10):302-6. German.
16. Abe R, Shichishima T, Ogawa K, Saitoh Y, Maruyama Y. Neutropenia due to parvovirus B19 infections in patients with paroxysmal nocturnal hemoglobinuria blood transfusion and natural infection cases. Acta Haematol 2006;116:245-8.
17. Bihari Ch, Rastogin A, Saxena P, Rangegowda D, Chowdhury A, Gupta N, et al. Parvovirus B19 associated hepatitis. Hepat Res Treat 2013; 2013:472027.
18. Nobili V, Vento S, Comparcola D, Sartorelli MR, Luciani M, Marcellini M. Autoimmune hemolytic anemia and autoimmune hepatitis associated with parvovirus B19. Pediatr Infect Dis J 2004;23(2):184-5.
19. American Academy of Pediatrics Committee on Infectious Diseases. Parvovirus B19. Kimberlin DW, Brady M, Jackson SA, Long SS, eds. 2015 Red Book: Report of the Committee on Infectious Diseases. 30th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2015. 593-6.
20. Crane J, Mundle W, Boucoiran I, Gagnon R, Bujold E, Basso M, et al. Parvovirus B19 infection in pregnancy. J Obstet Gynaecol Can 2014 Dec;36(12):1107-16.
21. Ornoy A, Ergaz Z. Parvovirus B19 infection during pregnancy and risks to the fetus. Birth Defects Res 2017 Mar 15;109 (5):311-23.
22. Zellman GL, Elston DM, Boysen M, Kwon KT, Slapper D, Vinson RP, et al. Erythema Infectiosum Clinical Presentation. Medscape. Updated: Jun 12, 2018.
23. Test ID: PARVS. Parvovirus B19 Antibodies, IgG and IgM, Serum. 995–2019 Mayo Foundation for Medical Education and Research. All Rights Reserved.