The Impact of Human Parvovirus B19 Infection on Heart Failure and Anemia with Reference to Iron Metabolism Markers in an Adult Woman

• Published in: Internal Medicine Vol. 57; no. 3; pp. 403 - 407
• Main Authors: Nakamura, Yuya, Ohsawa, Isao, Goto, Yoshikazu, Namba, Hokuto, Dodo, Yusuke, Tsuji, Mayumi, Kiuchi, Yuji, Inagaki, Masahiro, Gotoh, Hiromichi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2018; Japan Science and Technology Agency
• Subjects: Anemia; Case Report; Differential diagnosis; Edema; erythroferrone; Exanthema; Fever; growth differentiation factor-15; Heart diseases; Heart failure; Hepcidin; hepcidin-25; human parvovirus B19; Immunoglobulin M; Infections; Internal medicine; Iron; Metabolism; Nutrient deficiency; Parvoviruses; Pleural effusion; heart failure; growth differentiation factor-15; hepcidin-25; human parvovirus B19; anemia; erythroferrone
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.8809-17

A 35-year-old woman with fever, edema and rash was admitted. Pleural effusion and cardiomegaly were observed. A laboratory analysis revealed anemia with iron deficiency and elevated human parvovirus B19 (B19V) immunoglobulin M. The patient's hepcidin-25 and erythroferrone levels were not elevated compared to those observed later in her clinical course. On the other hand, her growth differentiation factor-15 (GDF-15) levels were elevated. She was diagnosed to have heart failure symptoms and anemia with specific iron metabolism abnormalities due to a B19V infection. After providing supportive treatment, the heart failure symptoms disappeared and her anemia had improved. This case emphasizes the need to include a B19V infection in the differential diagnosis when we encounter cases demonstrating reversible heart failure with anemia.