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Query: UMLS:C0002895 (sickle cell disease)
 11,747 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The development, pharmacology, effectiveness, adverse reactions and clinical use of polyvalent pneumococcal vaccines are reviewed. Patients with sickle cell anemia, asplenic and elderly patients, infants and closed populations are particularly susceptible to Streptococcus pneumoniae infections. Polyvalent pneumococcal vaccine induces a satisfactory antibody response wihin about two weeks which declines with time but generally remains elevated for at least 20 months after infection. The vaccine has been reported to reduce the incidence of pneumococcal disease by 76 to 100% and to reduce the carrier rate of pneumococci covered by the vaccine; however, infants younger than two years of age repond inconsistently. Local reactions to the vaccine (soreness at injection site, erythema, induration and tenderness) occur in 86% of adults and nearly all children. The incidence of adverse reactions increases on revaccination. The recommendations of the U.S. Public Health Service and Center for Disease Control on use of the vaccine are presented. Mass immunization with the vaccine is not recommended, but the vaccine may be of benefit in sickle cell, asplenic and elderly patients, and in closed populations.
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PMID:Polyvalent pneumococcal vaccines: a review. 38 Mar 32

In the spring and summer of 1988, two separate outbreaks of an illness with a rash resembling erythema infectiosum occurred among members of the nursing staff of the Children's Hospital of Philadelphia. The sources were two adolescent patients with sickle cell disease and aplastic crisis who had unsuspected parvovirus infection. Tests for IgM and IgG antibodies to parvovirus B19 were positive in both patients, and electron microscopical examination showed parvovirus-like particles in the early serum samples. Of 40 health care workers exposed to infected patients, 12 (30 percent) were infected, 2 (5 percent) were possibly infected, 8 (20 percent) had evidence of a past infection with B19, and 18 (45 percent) remained seronegative. Attack rates among the susceptible contacts were 36 percent in the first outbreak and at least 38 percent in the second. Clinical symptoms began a mean of 12.6 days after exposure and included malaise, rash, and joint pain. We conclude that hospital workers are at risk of contracting nosocomial erythema infectiosum from patients with parvovirus-associated aplastic crisis. We recommend that all patients with hereditary hemolytic anemias who are admitted with a febrile illness be evaluated for aplasia and promptly placed in respiratory and contact isolation if aplastic crisis is suspected.
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PMID:Human parvovirus B19 infection among hospital staff members after contact with infected patients. 254 99

Discovered by chance in 1974, the human serum parvovirus B19 is at present the only recognized, autonomous, pathogenic human parvovirus. For some years following its discovery, B19 was not associated with any defined clinical syndrome; although a high titre viraemia was often noted in infected individuals they were largely asymptomatic. In 1980 the causal association between B19 infection and aplastic crisis in chronic haemolytic anaemia began to emerge with the discovery of B19 as the agent responsible for aplastic crisis in sickle cell anaemia. This fulfilled the expectation of a disease of tissue comprising a large proportion of dividing cells, namely the erythropoietic elements of the bone marrow, anticipated in autonomous parvovirus infection where viral replication is confined to dividing cells. More recently, erythema infectiosum, an illness sharing many of the clinical features of rubella, has been found to be the common result of B19 infection, although a spectrum of disease is now emerging. Much effort is currently directed toward the elucidation of the effects of maternal B19 infection on the developing fetus.
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PMID:Human parvovirus infections. 282 52

B19 virus is the first human virus to be shown to be a member of the parvovirus genus. This review is concerned with the diseases associated with B19 virus, their nature, pathogenesis and diagnosis. The virus was discovered by chance in blood donors but has been shown to be a common infection of childhood. Infection may be asymptomatic or associated with mild, non-specific symptoms. The most common specific clinical manifestation is an erythematous rash illness which often has the classical features of erythema infectiosum. Often, however, it is described simply as rubelliform and only laboratory tests can distinguish B19 and rubella virus infections. Joint involvement is the most common complication of B19 virus infection occurring especially in adult females. It often involves the joints of the hands and wrists, clears rapidly in most patients but may persist for months or years in a few. B19 virus is also the principle cause of the transient aplastic crisis which complicates chronic haemolytic anaemia. This has been demonstrated repeatedly in sickle cell anaemia and hereditary spherocytosis and in individual cases of other haemolytic anaemias. The pathogenesis of the aplastic crisis is related to the ability of B19 virus to infect and damage early erythroid progenitor cells. Volunteer studies in normal individuals have demonstrated that this is a regular event occurring about a week after infection via the respiratory tract. Rash illness and joint involvement occur 7 to 10 days later and are presumably immune mediated. Diagnosis of B19 virus infection can be achieved by detection of the viraemia (aplastic crisis) or by detection of virus specific IgM antibody (all diseases).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:B19 virus--a pathogenic human parvovirus. 284 30

Human parvovirus (HPV) infection has recently been implicated as the cause of aplastic crisis in patients with hemolytic anemias such as congenital spherocytosis and sickle cell anemia. The virus causes a transient red cell aplasia which, in patients with a shortened red cell life span, is manifested as a rapid worsening of the anemia and an absence of peripheral reticulocytosis. Recovery is associated with the presence of giant pronormoblasts in the bone marrow, and several days later, a brisk peripheral reticulocytosis. In normal subjects, HPV causes erythema infectiosum (fifth disease) but is not associated with symptomatic anemia, probably because of the duration of the normal red blood cell life span. A case of HPV infection producing severe anemia in an immunocompromised patient without an underlying hemolytic anemia is presented here. Infection in this patient, a 3-year-old boy with acute lymphoblastic leukemia in remission, may have been prolonged by immunosuppression, leading over a 4-week period to a severe anemia. The immunosuppressed appear to be another group of patients at risk of developing symptomatic anemia when infected by HPV.
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PMID:Human parvovirus-associated red cell aplasia in the absence of underlying hemolytic anemia. 302 Oct 15

Human parvovirus (HPV) infections have been associated with several clinical syndromes. The virus is the etiologic agent of erythema infectiosum (fifth disease) and the primary cause of aplastic crises in children with sickle cell disease and other hemolytic anemias. Some individuals with an acute symmetric polyarthritis were found to have a recent HPV infection. Although two stillborn infants with proved HPV infections have been identified, the exact relationship among HPV, intrauterine infection, and subsequent fetal damage requires further research.
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PMID:Parvovirus infections in childhood. 303 37

The human parvovirus B19 causes aplastic crises in sickle cell anemia patients and the disease erythema infectiosum. So far, it has not been possible to grow B19 virus in cultured cells. Here we report the use of in vitro transcription in HeLa cell extracts and transient expression of cloned DNA transfected into HeLa cells to detect and map a strong transcriptional promoter on the B19 genome. The promoter is located near the left end of the B19 genome, at position 6 map units in the clone pYT103 (approximately 280 bp upstream of the first HindIII site), and directs transcription to the right. These results suggest that the strictly limited host range of B19 does not operate at the level of transcription from the promoter at the left end of the genome.
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PMID:A transcriptional promoter of the human parvovirus B19 active in vitro and in vivo. 382 10

The clinical features of long bone infarction in patients with sickle cell disease have not been well defined, and differentiation of bone infarct from osteomyelitis has accordingly been difficult. We reviewed records from 192 children with sickle hemoglobinopathies and identified 41 episodes of acute long bone infarction in 21 patients. The most commonly affected bones were the humerus (38%), tibia (23%), and femur (19%). The distal segment was more commonly involved. Tenderness and prominent swelling occurred in all cases; other findings included impaired joint motion (68%), local heat (65%), and erythema (145). Fever was usually absent or low grade, and patients did not appear ill. Laboratory studies included negative bacterial cultures in all cases, absence of left shift in WBC count in most, and variable erythrocyte sedimentation rate. Plain roentgenographs were unremarkable. Contrary to previous reports, radionuclide bone and bone marrow scans were not helpful in differentiation of bone infarction from osteomyelitis. Patients received supportive therapy and improved within several days. Long-term sequelae were not evident. The rarity of osteomyelitis in our sickle cell population (five cases in 22 years) precluded direct comparison of most of its clinical features with those of bone infarction. Acute long bone infarction is at least 50 times more common than bacterial osteomyelitis in sickle cell disease.
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PMID:Acute infarction of long bones in children with sickle cell anemia. 709 7

Human parvovirus B19 has been associated with several diseases. Aplastic crisis in patients with chronic hemolytic anemia, erythema infectiosum, hydrops fetalis and arthritis are among the common diseases caused by this virus infection. In the period between July, 1991, and March, 1992, 48 patients with aplastic crises were hospitalized at Saudi Aramco-Dhahran Health Center, Dhahran, Saudi Arabia. Forty-six patients had homozygous sickle cell disease, one had hemoglobin H disease and one had hereditary elliptocytosis. Evidence of recent human parvovirus infection was present in 91% of the cases. Leukopenia was present in 21%, neutropenia in 27% and thrombocytopenia in 42%. This differs from previous reports in which red blood cell aplasia causing anemia was the only hematologic finding reported in most patients. There were no cases of erythema infectiosum in either the patients or the community during the epidemic and the reason for this phenomenon is not obvious. The almost limited occurrence of aplastic crisis in patients with sickle cell disease in a population with a high incidence of other types of chronic hemolytic anemias is of interest.
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PMID:An epidemic of aplastic crisis caused by human parvovirus B19. 771 86

Parvovirus B19 is usually associated with an acute, self-limited disease in children. In patients with a congenital hemolytic anemia, infection with this virus can cause an aplastic crisis. We describe such a crisis in an adult with asymptomatic hereditary spherocytosis. The association between acute red blood cell aplasia and infection with parvovirus B19 is well described in patients with hereditary hemolytic anemia, particularly sickle cell anemia. This association has also been described, although less frequently, in patients with other inherited hemolytic diseases, such as hereditary spherocytosis. In children, human parvovirus B19 causes an acute self-limited illness known as erythema infectiosum (fifth disease). In immunocompromised individuals, chronic infections can occur and cause a severe, persistent anemia. In pregnant women, infection can, but usually does not, lead to fetal infection. An infected fetus can have severe anemia, congestive heart failure, generalized edema (fetal hydrops) and even death. Most cases of aplastic crises associated with parvovirus B19 in patients with hereditary spherocytosis have been reported in children and adolescents. In this paper we describe an aplastic crisis in a 28 year old man with asymptomatic hereditary spherocytosis.
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PMID:Aplastic crisis associated with parvovirus B19 in an adult with hereditary spherocytosis. 930 16


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