Janak Kishore
Sanjay Gandhi Post-Graduate Institute of Medical Sciences, India
Title: Expanding spectrum of Parvovirus B19 in Paediatric Infections: what’s more than Fifth’s Disease
Biography
Biography: Janak Kishore
Abstract
Fifth disease or Erythema infectiosum (EI) in children was known prior to its discovery of B19 in 1974 (reviewed in Kishore J, Kapoor A; 2000) but only after 7 yrs later disease causation by B19 were first recognized as TAC (1981) then arthropathy (1983) & non-immune hydrops fetalis (1987). Since then clinical spectrum of B19 infections were found increasingly hence we developed diagnostic tools for B19 (ELISA, PCR) and determined its seroprevalence (39.9%) in 1000 blood-donors (Kishore J et al; 2005, 2010). We reported novel, unique cases of pure acquired amegakaryocytic thrombocytopenia in a 9 mo male (Kishore J et al; 2005) and another case of myositis in 9 yr female as a complication of EI (Kishore J et al; 2006) supported later by other investigators. Again cases of thrombocytopenia and anaemia in a child with fulminant hepatitis due to B19 infection (Kishore J et al; 2009) and a fatal case of hemophagocytic lymphohistiocytosis induced by B19 and EBV in a 2 mo male infant were reported (Kishore J et al; 2014). Major studies included juvenile rheumatoid arthropathy (fulfilling ARA criteria) in 82 children and B19 infection was found in 27 % (Kishore J et al; 1998). Foetal wastage in recurrent aborters and in high risk pregnant women (n=60) revealed high proportions with B19 infection (Kishore J et al; 2011, 2006). Multi-transfused beta-thalassemia major (n=92) children (mean age 8 yrs) had high frequency of anti-B19 IgM (41.1%) antibodies (Kishore Jet al; 2011). In 29 paediatric leukaemia (mostly ALL) we reported (Kishore J et al; 2011) prolonged induction therapy, persistent anaemia while mortality was 17% in B19 infected group but nil in un-infected group indicating B19 may be naturally Oncolytic (Kishore J; 2014) further prolonged remission in a child with CLL and another with CML (co-author Kishore J; 2015) ratified our clinical observations. Now several reports on paediatric B19 infections have cumulated to signify big role of B19 virus but unfortunately B19 infections are largely ignored.