Autoimmune-like pulmonary disease in association with parvovirus B19: A clinical, morphologic, and molecular study of 12 cases

Cynthia M. Magro, Raghav Wusirika, Gwyn E. Frambach, Gerard J. Nuovo, Clodoveo Ferri, Patrick Ross

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Parvovirus B19, the agent responsible for fifth disease, has been emerging as a significant pathogenetic factor in various acute vasculitic syndromes such as Wegener's granulomatosis, Henoch-Schönlein purpura, and Kawasaki disease. It has also been implicated in more chronic vasculopathic syndromes, specifically in the context of scleroderma and dermatomyositis. The basis of this association is likely multifactorial; implicated mechanisms include the virus's affinity for endothelium, resulting in a state of neoantigenicity through varied mechanisms as well as the induction of tumor necrosis factor alpha, a factor involved in the propagation of ANCA-positive vasculitic syndromes. The authors present a series of 12 patients with interstitial lung disease including idiopathic pulmonary fibrosis, scleroderma-associated pulmonary fibrosis, lymphocytic interstitial pneumonitis, and septal capillaritis. In all cases there was evidence of chronic parvovirus B19 infection based on serologic assessment and the isolation of B19 DNA on lung samples in all patients. Furthermore, in two cases there was in situ localization of B19 RNA and tumor necrosis factor alpha to endothelium and stromal cells. On pathologic examination, there were varying degrees of both septal fibrosis and inflammation along with evidence of septal capillary injury. In those cases categorized as representing either scleroderma or idiopathic pulmonary fibrosis, the immunofluorescent studies showed evidence of anti-endothelial cell antibody formation. The ANCA-associated syndromes were, as expected, negative by fluorescent analysis. Significantly elevated factor VIII levels, a standard serologic index of endothelial cell injury, were seen in four of the six patients tested. The antiphospholipid profile revealed antiphospholipids in 7 of the 11 patients tested. This report highlights a possible causal role for parvovirus B19 in the pathogenesis of select pulmonary disorders.

Original languageEnglish (US)
Pages (from-to)208-216
Number of pages9
JournalApplied Immunohistochemistry and Molecular Morphology
Volume14
Issue number2
DOIs
StatePublished - Jun 2006
Externally publishedYes

Fingerprint

Parvovirus
Lung Diseases
Antineutrophil Cytoplasmic Antibodies
Idiopathic Pulmonary Fibrosis
Interstitial Lung Diseases
Endothelium
Erythema Infectiosum
Tumor Necrosis Factor-alpha
Parvoviridae Infections
Schoenlein-Henoch Purpura
Lung
Mucocutaneous Lymph Node Syndrome
Granulomatosis with Polyangiitis
Dermatomyositis
Pulmonary Fibrosis
Wounds and Injuries
Factor VIII
Stromal Cells
Antibody Formation
Fibrosis

Keywords

  • Autoimmune
  • Parvovirus B19
  • Pulmonary

ASJC Scopus subject areas

  • Anatomy
  • Medical Laboratory Technology

Cite this

Autoimmune-like pulmonary disease in association with parvovirus B19 : A clinical, morphologic, and molecular study of 12 cases. / Magro, Cynthia M.; Wusirika, Raghav; Frambach, Gwyn E.; Nuovo, Gerard J.; Ferri, Clodoveo; Ross, Patrick.

In: Applied Immunohistochemistry and Molecular Morphology, Vol. 14, No. 2, 06.2006, p. 208-216.

Research output: Contribution to journalArticle

Magro, Cynthia M. ; Wusirika, Raghav ; Frambach, Gwyn E. ; Nuovo, Gerard J. ; Ferri, Clodoveo ; Ross, Patrick. / Autoimmune-like pulmonary disease in association with parvovirus B19 : A clinical, morphologic, and molecular study of 12 cases. In: Applied Immunohistochemistry and Molecular Morphology. 2006 ; Vol. 14, No. 2. pp. 208-216.
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