Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027947 (neutropenia)
 17,527 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We diagnosed infections from human parvovirus B19 in three patients by using dot-blot hybridization and a polymerase chain reaction to detect B19 DNA and using an enzyme immunoassay to detect IgG and IgM to B19. For 5 months a 5-year-old boy with acute lymphoblastic leukemia in remission had anemia without reticulocytes or bone marrow erythrocyte precursors. His serum lacked IgG and IgM to B19 but contained B19 DNA. He received gamma globulin intravenously (0.4 gm/kg/day for 5 days); his viremia promptly cleared and reticulocytosis developed. A 14-year-old boy with acute lymphoblastic leukemia in remission had fever, rash, neutropenia (less than 300 leukocytes/mm3), and a hemophagocytic syndrome lasting 3 weeks. His serum contained IgM to B19 and B19 DNA. Without therapy, IgG to B19 developed; although low levels of B19 DNA persisted, the leukocyte count returned to normal. In a 19-year-old patient with systemic lupus erythematosus and hemolytic anemia, an aplastic crisis lasted 2 weeks. Her serum lacked IgG and IgM to B19 but contained B19 DNA. Without therapy, IgG and IgM to B19 appeared, viremia diminished, and reticulocytosis occurred. These patients illustrate the varied manifestations of chronic B19 infections, the importance of DNA detection for diagnosis, and the possible efficacy of gamma globulin therapy.
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PMID:Manifestations and treatment of human parvovirus B19 infection in immunocompromised patients. 168 74

Hydrops fetalis was diagnosed at 22 weeks. An ultrasound examination demonstrated cardiomegaly and a fetal blood specimen obtained by cordocentesis revealed thrombocytopenia, anaemia, and neutropenia. Fetal paracentesis yielded straw-coloured fluid with electrolytes indicative of a transudate. Non-enveloped icosahedral viral particles approximately 23 mm in diameter were visualized in the ascitic fluid by electron microscopy. Immune electron microscopy confirmed human parvovirus B19. Direct fetal digitalization led to a reduction in umbilical artery resistance, a decline in the abdominal circumference from 20.3 to 17.8 cm, and resolution of the ascites within 72 h. Despite this dramatic response to therapy, fetal death occurred on day 5 of treatment. The initial maternal serum was positive for anti-B19 IgM and IgG antibodies. Electron microscopy of fetal cardiac tissue obtained post-mortem revealed intranuclear viral particles typical of B19, confirming the antenatal diagnosis of myocarditis. This case demonstrates that direct viral identification is applicable to prenatal diagnosis. To our knowledge, this is the first reported case of the antenatal diagnosis and palliative treatment of fetal viral infection.
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PMID:Antenatal diagnosis and palliative treatment of non-immune hydrops fetalis secondary to fetal parvovirus B19 infection. 246 84

We report on 4 children with transient erythroblastopenia complicated by thrombocytopenia and/or neutropenia. Bone marrow examination revealed severe erythroid hypoplasia with normal granulopoiesis and thrombopoiesis. Human parvovirus B19 infection was confirmed serologically in 2 children. An in vitro study using autologous bone marrow cells after recovery demonstrated IgG-mediated inhibition of erythropoiesis in 4 children. Additionally, antibodies directed against platelets and neutrophils were detected. These findings suggest that the IgG-mediated mechanism may be pathogenetic for the transient pancytopenia of these children.
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PMID:Childhood transient erythroblastopenia complicated by thrombocytopenia and neutropenia. 291 97

Recovery of bone marrow function in aplastic anemia patients treated with immunosuppressive therapy first suggested a role for the immune system in bone marrow failure. High recovery rates in patients treated with immunosuppressive therapy suggested that an immune mechanism may be a final common pathway of marrow failure in this disease. In vitro studies have shown that aplastic peripheral blood and marrow cells and their supernatants are capable of suppressing hematopoiesis by autologous and normal marrow. Soluble factors identified in this system include gamma interferon and lymphotoxin. The interaction of these molecules with positive growth factors, the role of synergy with other negative regulators, and their role in the pathogenesis of bone marrow failure are discussed. Lymphokine and lymphocyte abnormalities in aplastic anemia may be manifestations of an underlying viral etiology. Three examples are discussed: Epstein-Barr virus-associated aplastic anemia; B19 parvovirus bone marrow failure; and HIV-induced neutropenia.
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PMID:Autoimmune aspects of aplastic anemia. 297 24

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

A young woman in maintenance therapy for acute lymphoblastic leukemia in second complete remission developed fever and a skin rash associated with severe anemia, neutropenia and erythroblastopenia. A complete recovery was obtained in 4 weeks' time after red cell transfusion, i.v. immunoglobulin and withdrawal of the maintenance chemotherapy. Parvovirus B19 infection was demonstrated by detection of B19 DNA in the patient's serum using a dot-blot hybridization assay and a nested polymerase chain reaction. Serological tests were positive for anti-B19 IgG but not for IgM. Erythroblastopenia due to parvovirus infection has already been reported in ALL patients. B19 infection should be suspected in leukemic patients if unexplained cytopenia (mainly anemia) follows an acute febrile illness. Very sensitive methods are often needed to confirm the diagnosis, since routine serological tests may be unreliable in immunocompromised patients.
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PMID:Cytopenia caused by parvovirus in an adult ALL patient. 792 75

After a period of general nonspecific symptoms (weakness; nocturnal sweating) for a few days a 29-year-old man suddenly developed a purpura-like rash on both hands and feet ("glove and sock") with mild itching and oedema. A blood count demonstrated leukopenia (2100/microliters) with neutropenia (1100/microliters), thrombocytopenia (81,000/microliters) and reticulocytopenia (1/1000), while haemoglobin content was normal. The bone-marrow showed almost complete reduction of erythropoiesis with the presence of giant proerythroblasts. Granulopoiesis and megakaryopoiesis were unremarkable. Positive tests for IgM and IgG antibodies against parvovirus B19 established the diagnosis of infection with this organism. The rash, blood picture and bone-marrow changes all regressed spontaneously, without any treatment, within a week. The petechial or purpuric "glove and sock" syndrome may be a special form of parvovirus B19 infection.
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PMID:[Hand and foot purpura ("glove and sock" syndrome) caused by parvovirus B19 infection]. 819 53

We describe a patient with both haemophagocytic syndrome and acute myocarditis probably associated with parvovirus B19 infection. The patient had a marked neutrophilia instead of neutropenia more usually observed in virus-associated haemophagocytic syndrome (VAHS). Endogenous serum concentrations of macrophage colony-stimulating factor (M-CSF), granulocyte colony-stimulating factor (G-CSF), and tumour necrosis factor-alpha (TNF-alpha) were higher than normal, suggesting that these cytokines may be involved in the genesis of the observed syndrome.
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PMID:Parvovirus B19-associated haemophagocytic syndrome with prominent neutrophilia. 819 40

Human parvovirus B19 (B19) is a known cause of erythema infectiosum (fifth disease) and aplastic crisis in patients with hemolytic anemias. When patients with malignant diseases are infected by B19 during chemotherapy, erythroid suppression of bone marrow sometimes occurs. We performed a retrospective investigation of B19 infection among 95 children with malignant diseases in our hospital during the past 14 years. By the method of dot blot hybridization, 9 of 95 patients were found to be positive for B19 DNA during chemotherapy. All 9 patients had reticulocytopenia at the time B19 DNA was detected in their serum samples. Neutropenia and thrombocytopenia were not found. Seven of them had only transient reticulocytopenia. Serum samples from 2 other patients were positive for B19 DNA for a longer time. They suffered from persistent anemia for about 2 and 13 month, respectively. The years when B19 DNA was detected from the 9 patients corresponded to the prevalence of erythema infectiosum in Japan.
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PMID:Retrospective study on the influence of human parvovirus B19 infection among children with malignant diseases. 823 78

Human parvovirus B19 is linked with a broadening spectrum of hematologic disorders, including aplastic crises in the context of hemolytic anemias, neutropenia, thrombocytopenia, and hemophagocytic syndromes. Children with any of these cytopenias should be screened for the presence of B19 because treatment with intravenous gamma globulin may provide resolution of abnormal blood counts if other therapeutic options, such as transfusion, are not adequate or desired.
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PMID:Diverse hematologic effects of parvovirus B19 infection. 864 11


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