PDF(Pubmed)
Abstract：
BACKGROUND: Parvovirus is a common childhood infection that could be very dangerous to the fetus, if pregnant women become infected. The spectrum of effects range from pure red blood cell aplasia with hydrops fetalis to meningoencephalitis, with many symptoms in between. Severe anemia in the setting of pure red blood cell aplasia is one of the more common effects that neonatal experience (if infected intrapartum), with the current gold standard treatment being intrauterine or postnatal packed red blood cell (PRBC) transfusions, yet intravenous immunoglobulin (IVIG) may be a superior treatment option.
METHODS: A preterm infant was born at 26th week of gestational age via emergency Cesarean section due to hydrops fetalis, with parvovirus B19 exposure one month prior. The infant tested positive for IgM antibodies against parvovirus B19. Among many other serious complications of both hydrops fetalis and premature delivery, the infant had severe unremitting anemia, and received many PRBC transfusion over the course of his 71-day-long neonatal intensive care unit stay. During a follow up appointments as outpatient, his blood tests showed persistent high copies of parvovirus B19. He was then supported with PRBC transfusions and treated with IVIG. After three doses of IVIG, the infant\'s parvovirus B19 viral copy numbers have dramatically reduced and the infant did not require any more PRBC transfusions.
CONCLUSIONS: IVIG infusion effectively treated the parvovirus B19 infection and restored erythropoiesis making the child transfusion independent. Furthermore, since IVIG is safe and readily crosses the placenta, further studies are needed to determine if IVIG should be considered as an alternative prenatal treatment for congenital parvovirus B19 infection.
METHODS: A preterm infant was born at 26th week of gestational age via emergency Cesarean section due to hydrops fetalis, with parvovirus B19 exposure one month prior. The infant tested positive for IgM antibodies against parvovirus B19. Among many other serious complications of both hydrops fetalis and premature delivery, the infant had severe unremitting anemia, and received many PRBC transfusion over the course of his 71-day-long neonatal intensive care unit stay. During a follow up appointments as outpatient, his blood tests showed persistent high copies of parvovirus B19. He was then supported with PRBC transfusions and treated with IVIG. After three doses of IVIG, the infant\'s parvovirus B19 viral copy numbers have dramatically reduced and the infant did not require any more PRBC transfusions.
CONCLUSIONS: IVIG infusion effectively treated the parvovirus B19 infection and restored erythropoiesis making the child transfusion independent. Furthermore, since IVIG is safe and readily crosses the placenta, further studies are needed to determine if IVIG should be considered as an alternative prenatal treatment for congenital parvovirus B19 infection.
摘要：
背景：细小病毒是一种常见的儿童感染，可能对胎儿非常危险，如果孕妇被感染。作用范围从纯红细胞再生障碍伴胎儿水肿到脑膜脑炎，中间有很多症状。在纯红细胞再生障碍性贫血的背景下，严重贫血是新生儿经历的最常见的影响之一（如果在产时感染），目前的黄金标准治疗方法是宫内或产后充血红细胞（PRBC）输血，然而静脉注射免疫球蛋白(IVIG)可能是一种较好的治疗选择.
方法：一名早产儿在胎龄第26周通过紧急剖宫产出生，原因是胎儿水肿，一个月前接触过细小病毒B19。该婴儿针对细小病毒B19的IgM抗体检测呈阳性。在胎儿水肿和早产的许多其他严重并发症中，婴儿患有严重的持续性贫血，在他71天的新生儿重症监护病房住院期间接受了许多PRBC输血。在门诊随访期间，他的血液检查显示细小病毒B19持续存在。然后他得到PRBC输血的支持，并接受IVIG治疗。三剂IVIG后，婴儿的细小病毒B19病毒拷贝数已显著减少,婴儿不再需要进行PRBC输血.
结论：IVIG输注可有效治疗细小病毒B19感染，并恢复红细胞生成，使儿童独立于输血。此外，因为IVIG是安全的，容易穿过胎盘，需要进一步的研究来确定IVIG是否应被视为先天性细小病毒B19感染的替代产前治疗.
方法：一名早产儿在胎龄第26周通过紧急剖宫产出生，原因是胎儿水肿，一个月前接触过细小病毒B19。该婴儿针对细小病毒B19的IgM抗体检测呈阳性。在胎儿水肿和早产的许多其他严重并发症中，婴儿患有严重的持续性贫血，在他71天的新生儿重症监护病房住院期间接受了许多PRBC输血。在门诊随访期间，他的血液检查显示细小病毒B19持续存在。然后他得到PRBC输血的支持，并接受IVIG治疗。三剂IVIG后，婴儿的细小病毒B19病毒拷贝数已显著减少,婴儿不再需要进行PRBC输血.
结论：IVIG输注可有效治疗细小病毒B19感染，并恢复红细胞生成，使儿童独立于输血。此外，因为IVIG是安全的，容易穿过胎盘，需要进一步的研究来确定IVIG是否应被视为先天性细小病毒B19感染的替代产前治疗.
