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Is there a correlation between parvos and anemia
Oct 23, 2003

In late may of this year I began to have severe pain in my right knee (a knee in which I have had cartilage damage in the past). The pain moved to my hips, shoulders, wrists and fingers.This appeared to be and was preliminarily diagnosed as some type of arthritis by both my family doctor and orthopedic surgeon. Blood testing, xrays and an MRI indicate that I didn't damage my knee.It did indicate that I was anemic. I have also learned from my family doctor that recent tests by my rheumatologist show positive for parvos.I have yet to get back in to see the rhuematologist, but I'm scheduled tomorrow to have an colonscopy to find out if there is an internal blood loss (at 53 yrs of age a good idea even if it not the problem here).I've also donated gallons of blood over the years.The last time in the middle of May. Is there a correlation between parvos and anemia? Could the anemia be caused by the parvos (if I do have it)? Could the blood donations have made me susceptible to parvos? I'm presently taking methotrexate, diclofenac and percocet. Thanks for any ideas you have.

Response from Dr. Frascino


Infection with parvovirus B19 is common; approximately 60% of adults worldwide have parvovirus B19-specific antibodies, indicating they have had previous exposure to the virus. It is transmitted predominantly by the respiratory route. You cannot get parvovirus by donating blood, but it is possible to get it from a blood transfusion (receiving blood).

Depending on a number of variables, including immunologic and hematologic status, parvovirus B19 can have a variety of presentations. In children, it often appears as a "slapped cheek" rash called erythema infectiosum or fifth disease. However in adults, especially in women, it can cause symmetrical joint problems. The small joints of the hands and feet are primarily involved with swelling and stiffness. This can evolve into a rather persistent arthritis, which can last for several years.

In people with underlying blood-related problems and/or immunodeficiency or immunosuppression, parvovirus B19 can cause chronic anemia and other blood problems (aplastic crisis).

Regarding treatment, in the majority of cases, the illness is benign and self-limited and requires no treatment other than symptomatic relief. Patients with joint pain and inflammation usually respond to nonsteroidal anti-inflammatory drugs. Persistent or highly symptomatic parvovirus B19 infection can be treated with intravenous immune globulin (IVIG), which, although not curative, is often dramatically effective. Your rheumatologist or a hematologist should be well acquainted with these treatment options, if parvovirus B19 turns out to be the cause of your problem. They should be able to guide you to your best options for treatment.

Hope this helps clarify things a bit. Good luck.

Dr. Bob

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