Article Text
Abstract
Objectives Description of clinical findings and evolution in a cohort of patients with recent human parvovirus B19(PB19) infection and arthritis.
Methods 26 patients with arthritis and recent PB19 infection (high titers of anti-PB19 Ig M antibodies) were studied. Clinical (prodromal symptoms, arthritis pattern, extra-articular features and evolution) and analytical (blood count, Erythrocite sedimentation rate, C-reactive protein, antinuclear antibodies, anti-DNA antibodies, anti-cardiolipin antibodies, C3/C4 levels and urine abnormalities) data were collected. SLE(ACR,1982), RA(ARA,1987), and Fibromyalgia (Wolfe,1995) criteria were reviewed in each case.
Results Mean age of the 26 patients (23 female, 3 male) was 38.6 years. Three patients (11.5%) fulfilled > = 4 ACR criteria for SLE, and four patients (15.4%) had an SLE-like syndrome. Joint symptoms always manifested as an abrupt-onset arthritis; mainly as a polyarthritis (92.3%) with an additive (76.9%), symmetric (84.6%) pattern. Most of the patients became symptom-free in a period not longer than less than six months (< = 8 weeks: 76.9%; 8–24 weeks: 7.6%), and only 4 patients had a chronic course (SLE-like:2 patients; SLE: 1 patient; fibromyalgia: 1 patient).
Conclusion Most of the patients with a recent PB19 infection show a self-limited symmetric additive polyarthritis. Some of this patients may fulfil SLE, SLE-like or fibromyalgia criteria. This virus could act as a trigger in the etiopathogenesis of this diseases.