Chronic parvovirus B19 infection and systemic necrotising vasculitis: opportunistic infection or aetiological agent?

Lancet. 1994 May 21;343(8908):1255-8. doi: 10.1016/s0140-6736(94)92152-0.


We describe three patients who had infection with human parvovirus B19 in association with new-onset systemic necrotising vasculitis syndromes, two with features of polyarteritis nodosa and one with features of Wegener's granulomatosis. Chronic B19 infection, lasting 5 months to more than 3 years, was shown by enzyme immunoassay for IgG and IgM antibodies to B19 and polymerase chain reaction for B19 DNA in serum and tissue samples. The patients had atypical serological responses to the B19 infection, although none had a recognisable immunodeficiency disorder. Treatment with corticosteroids and cyclophosphamide did not control vasculitis. Intravenous immunoglobulin (IVIG) therapy led to rapid improvement of the systemic vascultis manifestations, clearing of the chronic parvovirus infection, and long-term remission. These observations suggest an aetiological relation between parvovirus B19 infection and systemic necrotising vasculitis in these patients and indicate a potentially curative role for IVIG in such disorders.

Publication types

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

MeSH terms

  • Adolescent
  • Base Sequence
  • Child, Preschool
  • Chronic Disease
  • DNA Primers
  • DNA, Viral / analysis
  • Erythema Infectiosum / complications*
  • Erythema Infectiosum / therapy
  • Female
  • Granulomatosis with Polyangiitis / immunology
  • Granulomatosis with Polyangiitis / microbiology*
  • Granulomatosis with Polyangiitis / therapy
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Male
  • Molecular Sequence Data
  • Parvovirus B19, Human / genetics
  • Parvovirus B19, Human / immunology
  • Parvovirus B19, Human / isolation & purification*
  • Polyarteritis Nodosa / immunology
  • Polyarteritis Nodosa / microbiology*
  • Polyarteritis Nodosa / therapy


  • DNA Primers
  • DNA, Viral
  • Immunoglobulins, Intravenous