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  • Open Access

Pediatric systemic lupus erythematosus and human parvovirus B19 infection

  • 1,
  • 1,
  • 2,
  • 3 and
  • 3Email author
Pediatric Rheumatology20119 (Suppl 1) :P267

https://doi.org/10.1186/1546-0096-9-S1-P267

  • Published:

Keywords

  • Systemic Lupus Erythematosus
  • Glomerulonephritis
  • Pericarditis
  • Consanguineous Family
  • Cerebral Vasculitis

Aim

To describe presentation and course of paediatric systemic lupus erythematosus (pSLE), associated with Parvovirus B19(PB19) primo-infection.

Methods

Retrospective monocentric study of patients with pSLE, defined according to ARA criteria, diagnosed before 16 years old, and associated with PB19 primo-infection, defined by the presence of PB19 IgM antibodies and PB19 DNA detected by PCR in blood and/or in tissue.

Results

3 girls aged from 8 years to 15 years 8 months have been included. PB19 infection was present at diagnosis in all patients. Maternal history of autoimmune diseases was noted in a consanguineous family. Clinical manifestations at diagnosis were fever(3), arthritis/arthralgia (3), skin rash (1), grade IV glomerulonephritis (1), interstitial pneumonia (1), cerebral vasculitis (1), pericarditis/pleurisy (1), adenopathy (2), hepatomegaly/splenomegaly (1). Aregenerative anaemia requiring packed red blood cell transfusion was present in all patients. AAN (3), anti –DNA (3), anti-SSa (1), anti-SSb (1), anti-phospholipid (1), anti-platelet (2), rheumatoid factor (2), pANCA (1), anti-actin (1) antibodies were found. PB19 PCR was positive in blood (3), bone marrow (2) and kidney (1). Corticosteroids have been initiated for the 3 patients, in association with one or more immunosuppressive therapies. A sustained remission has been observed in 2 patients after a follow-up of 4 years and 1 year 8 months off-therapy respectively. A severe course with joint damages, recurrent pericarditis and gradeIV glomerulonephritis, associated with persistent infection by PB19, has been observed in the third case (family autoimmunity history).

Conclusion

PB19 infection-associated-pSLE may evolve either to a persistent remission off-therapy or to a severe pSLE. It should be considered in patient with pSLE associated with a severe aregenerative anemia.

Authors’ Affiliations

(1)
Pediatric unit, Jean Verdier hospital, 93140 Bondy, France
(2)
Pediatric Nephrology unit, Necker hospital, 75015 Paris, France
(3)
Pediatric Immunology Rhumatology unit, 75015 Paris, France

Copyright

© Bélien-Pallet et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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