Parvovirus B19 in the acute arthropathies and juvenile rheumatoid arthritis

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Journal of Paediatrics and Child Health

Volume 38 Issue 4 Page 358  - August 2002

 

Parvovirus B19 in the acute arthropathies and juvenile rheumatoid arthritis

F Oguz 1 C Akdeniz 1 E Ünüvar  1 Ö Küçükbasmaci 2 and M Sidal1

Objective: To evaluate the prevalence of recent parvovirus B19 infection in

a cohort of children presenting with acute arthropathy and to determine the

prevalence of a subsequent diagnosis of juvenile rheumatoid arthritis in

this cohort.

Method: In this prospective study, parvovirus B19 IgM antibody was

investigated in 75 patients who were referred to our clinic with acute joint

complaints and also in 75 healthy controls. One patient in each group was

excluded due to neuroblastoma and acute lymphoblastic leukaemia. The

characteristics of parvovirus B19 IgM positive patients who were accepted as

parvovirus B19 arthropathy were further evaluated. All the patients were

followed up for at least 6 weeks and the patients with chronic progression

of joint complaints were followed for at least 6 months to determine their

progress. The cases of juvenile rheumatoid arthritis in this chronic group

were identified.

Results: Parvovirus B19 IgM was detected in 16 of 74 patients (21.6%) with

acute arthropathy compared with 3 of 74 (4.1%) in the healthy control group

(2 = 8.67; P = 0.003). The parvovirus B19 positive patients with arthropathy

were more likely to become chronic (P = 3.7 107) and to be diagnosed as

juvenile rheumatoid arthritis (P = 0.03) than the parvovirus B19 IgM

negative group with arthropathy. Additional joint destruction developed in

one case who was parvovirus B19 IgM positive in whom juvenile rheumatoid

arthritis was diagnosed during follow up.

Conclusion: These data support the hypothesis that parvovirus B19 infection

may be associated with the onset of juvenile rheumatoid arthritis in a

proportion of patients.