Pericarditis and pleuritis associated with human parvovirus B19 infection in a systemic lupus erythematosus patient.

Human parvovirus B19 (PVB19) infection sometimes shows systemic lupus erythematosus (SLE)-like symptoms. We present an SLE patient showing pericarditis and pleuritis with a fever and an acute swelling of extremities 2 months after the fist consultation. Initially, a diagnosis of SLE exacerbation was made. Additional laboratory examination showed positive results for immunoglobulin M (IgM) antibody to PVB19 and PVB19 DNA in serum and pleural effusion at that time. After 1 month, PVB19 DNA in serum and IgM antibody to PVB19 was negative. Based on these findings, a final diagnosis of PVB19 infection in an SLE patient was made. PVB19 infection should be taken into consideration for SLE with acute swelling of the extremities and fever, as these symptoms are often observed in adult cases of PVB19 infection. Steroid pulse therapy rapidly improved these symptoms, and later the dose of steroid was reduced to 5 mg/day of prednisolone. Thus, steroids may be one of the choices for severe and/or rapidly progressive symptoms of pericarditis and pleuritis due to PVB19 infection.