Human parvovirus B19 is the cause of several distinct clinical syndromes. The most common is erythema infectiosum (fifth disease), a febrile exanthem occurring primarily in children. Recent studies have shown that parvovirus B19 can cause acute arthritis and occasionally a chronic arthropathy, both in children and adults. Parvovirus B19 DNA has been detected in studies in the synovial tissue of patients with rheumatoid arthritis, but other studies have varied in their findings. Recent studies also indicate a possible connective tissue disease–like syndrome with parvoviral infections. The common features of this syndrome are malar eruption, arthralgias, arthritis, and laboratory abnormalities including antinuclear antibody and rheumatoid factor positivity. However, the data indicate it is unlikely that B19 infection causes rheumatoid arthritis or systemic lupus erythematosus. Continued studies of the pathogenesis of acute and chronic parvoviral B19 infections and arthropathy may provide insights into virus–host interactions and mechanisms of joint disease and connective tissue disease.
Professor of Internal Medicine and Pediatrics, Director, Division of Rheumatology and Pediatric Rheumatology, Saint Louis University Health Sciences Center, St. Louis, Missouri, USA
Correspondence to Terry L. Moore, MD, Division of Rheumatology and Pediatric Rheumatology, Saint Louis University Health Sciences Center, Room 211 A Doisy Hall, 1402 South Grand Boulevard, St. Louis, MO 63104, USA; e-mail: MooreTL@slu.edu