Erythema nodosum manifestation of Parvovirus B19-associated reactive arthritis

Abstract

Introduction: Parvovirus B19 virus-mediated viral inflammation and immune-complex deposition generate mainly short-term manifestations in the affected individuals. The objective of this study was to determine Parvovirus B19 infection in rheumatoid arthritis (RA) patients.

Methodology: The study employed 50 patients diagnosed with RA and 30 healthy individuals. Blood samples were collected from both groups. The blood samples were screened for Parvovirus B19 infection using polymerase chain reaction to detect B19 DNA and enzyme-linked immunosorbent assay to detect anti-B19 IgM and IgG.

Results: 17 (34%) of 50 patients tested positive for parvovirus B19 DNA. In contrast, the mortality rate in the control group was significantly lower (6.7%; p = 0.005). Anti-B19 IgG antibody levels differed significantly with patients and control (p = 0.007), whereas anti-B19 IgM Ab levels did not (p = 0.6). There was a significant correlation between viremia B19 and all measured parameters. Parvovirus-affected patients had significantly higher CRP and ESR, elevated DAS28 scores, and more joint pain compared to parvovirus (-) patients.

Conclusion: Anti-CCP and RF values were significantly high in parvovirus (+) patients. Joint erosion was also prevalent in patients who tested positive for parvovirus. The findings of this study suggest that infection with parvovirus in patients with RA, and a possible role of this viral infection in the pathogenesis of RA may contribute to the pathogenesis of RA.