RESUMEN
BACKGROUND/PURPOSE: Human parvovirus B-19 (PB-19) is a cause of hemolysis, red blood cell aplasia, and severe conditions in patients with sickle cell anemia, but the molecular mechanisms of the infection are still insufficiently understood. This study aimed to detect PB-19 DNA together with its antibodies in the sera of Egyptian children with sickle cell disease and to assess the contribution of this infection, which causes transient cessation of erythropoiesis, in precipitating severe anemia in some cases. METHODS: One hundred children with sickle cell disease seeking medical advice in the pediatric-hematology clinic were recruited. Sera of the patients were compared with those of 60 healthy children regarding the presence of PB-19 immunoglobulin (Ig)G and IgM as well as detection of its DNA by nested-polymerase chain reaction technique. RESULTS: There were statistically significant differences in the prevalence of PB-19 IgM, IgG, and DNA among patients when compared with controls (p < 0.001, p = 0.001, and p < 0.001 respectively). Acute PB-19 infection detected by positive IgM and DNA was found in 30% of the patients, while chronic PB-19 infection detected by positive IgG and DNA was detected in 24% of the patients. Anemia was worse in children with acute PB-19 infection than in those with chronic infection, while anemia was mild in children with old infection. CONCLUSION: PB-19 infection is detected at high rates among Egyptian children with sickle cell disease and it may result in severe anemia. So, PB-19 must be suspected and screened for in such group of patients.
Asunto(s)
Anemia de Células Falciformes/complicaciones , Anticuerpos Antivirales/sangre , Infecciones por Parvoviridae/diagnóstico , Infecciones por Parvoviridae/epidemiología , Infecciones por Parvoviridae/inmunología , Parvovirus B19 Humano/aislamiento & purificación , Anemia , Niño , ADN Viral/sangre , ADN Viral/aislamiento & purificación , Egipto/epidemiología , Femenino , Hospitales , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Estudios Observacionales como Asunto , Infecciones por Parvoviridae/virología , Parvovirus B19 Humano/genética , Parvovirus B19 Humano/inmunología , Parvovirus B19 Humano/patogenicidad , Reacción en Cadena de la Polimerasa/métodos , Prevalencia , Estudios ProspectivosRESUMEN
Abstract The aim of this study was to identify pregnant women at risk of preeclampsia (PE) before clinical manifestations appeared using a panel of serum markers. We recruited 240 consecutive women who presented for antenatal care. We investigated whether serum levels of placental growth factor (PlGF), its inhibitor, soluble fms-like tyrosine kinase-1 (sFlt-1), measured at 13-16 weeks gestation and the expression of fms-like tyrosine kinase-1 (Flt-1) in the maternal neutrophils measured by flow cytometry could be predictive of the subsequent development of PE. Serum PlGF levels were found to be significantly lower among women who developed PE than patients with gestational hypertension or patients in the control group (p < 0.001). In contrast, serum sFlt1 levels were most elevated in patients who developed PE versus those with gestational hypertension or the control group (p < 0.001). Serum levels of neutrophil-Flt-1, however, were lower in women who developed PE than in those with gestational hypertension or those in the control group (p < 0.001). Increased serum levels of sFlt-1, decreased levels of neutrophil-Flt-1, and decreased levels of PlGF may predict women at risk of developing PE later in pregnancy.