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Paradoxical response to intravenous immunoglobulin in a case of Parvovirus B19-associated chronic fatigue syndrome
Affiliation:1. University of Bologna, Department of Medicine and Surgery, Division of Infectious Diseases, S.Orsola-Malpighi Hospital, Bologna, Italy;2. University of Bologna, Department of Pharmacy and Biotechnology, S.Orsola-Malpighi Hospital – Microbiology, Bologna, Italy;3. University of Bologna, Department of Diagnostic, Experimental and Specialty Medicine, S.Orsola-Malpighi Hospital – Microbiology, Bologna, Italy;1. Department of Microbiology Sanjay Gandhi Post-Graduate Institute of Medical Sciences (JK), Department of Pediatrics, Dr. Shyama Prasad Mukherjee (Civil) Hospital, Lucknow, Uttar Pradesh, India (DK);1. Department of Microbiology (VIA, RS), Department of Ear, Nose, and Throat (DRS), Mathikere Sampangi Ramaiah Medical College, Bangalore, Karnataka, India;1. School of Science, Shanghai University, Shanghai, 200444, China;2. School of Science, Hangzhou Dianzi University, Hangzhou, Zhejiang, 310018, China;3. College of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, China;1. Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, 1040 Vienna, Austria;2. German Red Cross, Blood Service for Baden-Württemberg-Hessen, Frankfurt, Germany;3. Department of Virology, Medical University of Vienna, Vienna, Austria;4. Bernhard Nocht Institute for Tropical Medicine, WHO Collaborating Centre for Arbovirus and Haemorrhagic Fever Reference and Research, Hamburg, Germany;5. German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Germany
Abstract:We describe a case of chronic fatigue syndrome (CFS) associated to Parvovirus B19 infection where administration of intravenous immunoglobulins (IVIG), previously reported as effective, induced a paradoxical clinical response and increased viral replication. The indication of IVIG administration in the treatment of Parvovirus B19-associated CFS should be carefully reconsidered.
Keywords:Chronic fatigue syndrome  Parvovirus B19  Intravenous immunoglobulin therapy
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