Immunologic Storm Simulating Systemic Lupus Erythematosus Following Parvovirus B19 Infection

González-Mazarío, Roxana and Suárez Álvarez, Luisa and Micó, Luisa and Moret Tatay, Inés and Salavert Lletí, Miguel (2015) Immunologic Storm Simulating Systemic Lupus Erythematosus Following Parvovirus B19 Infection. European Journal of Case Reports in Internal Medicine, 2 (1). pp. 1-8. ISSN 2284-2594

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Background: The appearance of symptoms compatible with systemic autoimmune diseases has been described in relation to several viral infections like HIV, cytomegalovirus and especially PVB19, depending on the evolution of the immunological condition of the host and their age. We present a young immunocompetent male patient, with clinical manifestations simulating systemic lupus erythematosus (SLE) with important activation of cytokines. Methods: For quantification of the different cytokines in plasma, a commercially available multiplex bead immunoassay, based on the Luminex platform (Cat # HSCYTO-60SK-08, Milliplex® MAP High Sensitivity, Millipore), was used according to the manufacturer’s instructions. All samples were run in duplicate and the data (mean fluorescence intensity) were analyzed using a Luminex reader. The mean concentration was calculated using a standard curve. Results: The clinical evolution was favourable without the need for any specific treatment, showing complete recovery after two months. Whilst the symptoms and viral charge were disappearing, the anti-DNA continued to increase and we demonstrate important activation of IL-10, IL-6 and TNFα cytokines as a result of a hyperstimulating response by an immunocompetent hyperfunctional system, which persists after clinical improvement. We should emphasize the behaviour of two cytokines: IL-12p70 and IL-2, which showed opposite tendencies. Conclusions: Viral infections, especially PVB19, can produce or simulate several autoimmune diseases as a hyperstimulation response from an immunocompetent hyperfunctional system. Consequently, a persistent increase of autoantobodies and important activation of cytokines, even after clinical improvement and seroconversion, can be demonstrated.

Item Type: Article
Uncontrolled Keywords: Parvovirus B19 infection, SLE, cytokines
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale) > 616.9 Altre malattie (altri rami della Medicina) > 616.91 Malattie da virus
Depositing User: Chiara D'Arpa
Date Deposited: 09 Sep 2016 14:53
Last Modified: 09 Sep 2016 14:53

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