Publication: A Case Of Congenital Parvovirus B19 Infection Diagnosed Through Placenta
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Date
2018
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College of Pathologist, AMM
Abstract
Introduction: Parvovirus B19 infection is a well-established cause of fetal death in hydrops fetalis. The diagnosis is usually made through histological identification of the characteristic nuclear inclusions in the placenta or fetal organs. However, the search for these inclusions are difficult at times particularly when placental sampling is limited or consent for fetal autopsy is not obtainable. We would like to share a case of congenital parvovirus infection with these characteristic inclusions and highlight the usefulness of immunohistochemistry. Case report: A 30-year-old lady, in her fourth pregnancy was referred for hydrops fetalis at 21 weeks gestation. She has three living children whom are currently well. Following induction of labour she delivered a male fetus. There were no dysmorphic features observed. However, the placenta was markedly large for gestational age, pale and friable with low fetoplacental ratio. On histology there were hydropic villi with increased nucleated red blood cells (RBC) within chorionic fetal vessels, many of which contained the characteristic intranuclear inclusions. They stained positively on immunostaining with parvovirus antibody. The parvovirus serology at the time of presentation was equivocal for IgM and positive for IgG. Other relevant microbiological investigations were negative. Discussion: Parvovirus infection is one of the commonly occurring intrauterine infections. Recognizing the histopathological features may aid in identifying the cause of intrauterine death as many of these women are asymptomatic. The use of immunostaining is very useful in confirming viral inclusions in the nucleated RBC and usually reveals a larger number of positive cells compared to H&E staining alone.
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Conference: The International Congress of Pathology & Laboratory Medicine 2018: Frontiers in Diagnostic Pathology
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Citation
Rahim, Nur & Fuad, Siti & Singh, Charnjeet & Zainun, Khairul & Rahman, Hayati. (2018). A case of congenital parvovirus B19 infection diagnosed through placenta.