Systemic monocyte and T-cell activation in a patient with human parvovirus B19 infection

Mayo Clin Proc. 1995 Mar;70(3):261-5. doi: 10.4065/70.3.261.


Infection with human parvovirus B19 induces a biphasic disease. The initial phase has been associated with viremia. During the second phase of the disease, a spectrum of clinical syndromes can manifest, including erythema infectiosum, perinatal complications, and symmetric arthropathy that resembles rheumatoid arthritis. Although investigators have suspected that some of the second-phase symptoms are related to immune complex formation, the pathogenesis of parvovirus B19-induced clinical manifestations is not understood. Herein we describe a 63-year-old woman with malaise, fever, and symmetric polyarthritis who had IgM antibodies specific for parvovirus B19. Messenger RNA (mRNA) specific for interleukin (IL) 1 beta, IL 6, and interferon-gamma (IFN-gamma) was detected by polymerase chain reaction. Transcript concentrations were semiquantified by serial dilution of cells and determination of the minimal number of cells that provided a positive signal. Concentrations of IL 1 beta and IL 6 mRNA in peripheral blood mononuclear cells collected during acute disease were increased by the factor of 32 and 8, respectively. IFN-gamma was detected at a 16-fold increased concentration. Two months later, after the patient had experienced complete recovery, production of monokines and IFN-gamma was almost normalized. These data raise the possibility that acute parvovirus B19 infection is characterized by a widespread and systemic activation of monocytes, T cells, and natural killer cells. The correlation of increased cytokine mRNA levels and clinical symptoms suggests a potential role of proinflammatory monokines and lymphokines in disease manifestations.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Base Sequence
  • Erythema Infectiosum / diagnosis
  • Erythema Infectiosum / immunology*
  • Erythema Infectiosum / physiopathology
  • Female
  • Humans
  • Interferon-gamma / biosynthesis*
  • Interferon-gamma / genetics
  • Interleukin-1 / biosynthesis*
  • Interleukin-1 / genetics
  • Interleukin-6 / biosynthesis*
  • Interleukin-6 / genetics
  • Middle Aged
  • Molecular Sequence Data
  • Monocytes / immunology
  • Polymerase Chain Reaction
  • RNA, Messenger / analysis
  • T-Lymphocytes / immunology*


  • Interleukin-1
  • Interleukin-6
  • RNA, Messenger
  • Interferon-gamma