Parvo virus and its impact on Lyme infection
By Linda on Jan 20, 2011 in Infections
Excerpt:
Several infectious agents may cause arthritis or arthropathy. For example,
infection with Borrelia burgdorferi, the etiologic agent of Lyme disease,
may in the late phase manifest as arthropathy. Infections with
Campylobacter, Salmonella or Yersinia may result in a postinfectious
reactive arthritis. Acute infection with parvovirus B19 (B19V) may likewise
initiate transient or chronic arthropathy. All these conditions may be
clinically indistinguishable from rheumatoid arthritis. Here, we present
evidence that acute B19V infection may elicit IgM antibodies that are
polyspecific or cross-reactive with a variety of bacterial antigens. Their
presence may lead to misdiagnosis and improper clinical management,
exemplified here by two case descriptions. Further, among
33 subjects with proven recent B19V infection we found IgM-enzyme immuno
assay
(EIA) positivity for Borrelia only, for Borrelia and Salmonella, for
Borrelia and Campylobacter, and for Borrelia, Campylobacer and Salmonella in
26 (78.7%),
1 (3%), 2 (6%), and 1 (3%), respectively, however, examined by Borrelia
LineBlot all samples were negative. These antibodies persisted over 3 months
in 4/13
(38%) patients tested. Likewise, in a retrospective comparison of the
results of a diagnostic laboratory, 9/11 (82%) patients with confirmed acute
B19V infection showed IgM to Borrelia. However, none of 12 patients with
confirmed borreliosis showed any serological evidence of acute B19V
infecion. Our study demonstrates that recent B19V infection can be
misinterpreted for secondary borreliosis or enteropathogen-induced reactive
arthritis. To perceive correct diagnosis we emphasize caution in
interpretation of polyreactive IgM and exclusion of recent B19V infection in
patients examined for infectious arthritis or arthropathy.
