J Rheum Dis.  2021 Jan;28(1):45-49. 10.4078/jrd.2021.28.1.45.

Transient Systemic Lupus Erythematosus-like Syndrome Associated With Parvovirus B19 Infection: A Case Report

Affiliations
  • 1Division of Rheumatology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
  • 2Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Human parvovirus B19 (HPV-B19) usually infects children. We report a case of an adult with HPV-B19 infection mimicking systemic lupus erythematosus (SLE). A previously healthy 46-year-old woman presented with an acute illness of cough, fever, chilling, polyarthritis, and skin rash. Laboratory findings showed pancytopenia, increased creatinine level, proteinuria and hypocomplementemia. Anti-double stranded DNA antibody (anti-dsDNA Ab) and antinuclear antibody were positive. Highly suspected of SLE based on clinical and laboratory findings, the patient was initially treated with corticosteroids. Meanwhile, the result of HPV-B19 polymerase chain reaction, which was done initially with other viral tests to exclude infection, turned out to be positive. Steroid was tapered, and pancytopenia, proteinuria, hypocomplementemia gradually improved. On the seventh day, anti-dsDNA Ab was found to be negatively converted. HPV-B19 infections are mostly self-limited and occur rarely in adults, but if a patient presents lupus-like syndrome with transient autoantibody positivity, lupus mimickers including HPV-B19 should be considered.

Keyword

Human parvovirus B19; Systemic lupus erythematosus

Figure

  • Figure 1 Time courses of laboratory data and treatment. WBC: white blood cells, Hb: hemoglobin, C4: complement 4, PLT: platelet count, anti-dsDNA: anti-double stranded DNA antibody.


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