Sources/Clones
Chemicon, Dako (polyclonal), Novocastra (R92F6) and Vector Laboratories (R92F6).
Fixation/Preparation
Applicable to archival formalin-fixed paraffin-embedded tissue sections. Before immunostaining, sections should be subjected to heat-induced epitope retrieval buffer at 100 C for 20 min (Liu et al, 1997).
Background
Human parvovirus B19 was accidentally discovered in 1975 in human serum being screened for hepatitis B surface antigen (Cossart et al, 1975). Since discovery, this virus has been found to be the causative agent in erythema infectiosum, chronic anemia in immunosuppressed patients, fetal death associated with hydrops and acute arthralgia/arthritis in adults (Liu et al, 1997).
Parvovirus B19, which is cytotoxic to erythroid progenitor cells in vivo and in vitro, enters the erythroid precursor cell via the blood group P antigen (Mortimer et al, 1983; Brown et al, 1993). In the past several years, human parvovirus B19 has been reported as a cause of severe and persistent anemia in patients immunocompromised from organ transplantation, autoimmune disease, hematologic malignancies, chemotherapy and congenital or acquired immunodeficiency states including HIV infection (Liu et al, 1997).
The R92F6 monoclonal antibody is directed against the VP1 and VP2 capsid protein of parvovirus B19.
Applications
On bone marrow smears and trephine biopsies, finding the giant erythroblast and small erythroid precursors with nuclear inclusions (lantern cells) establishes the diagnosis. However, these cells may easily be overlooked by the inexperienced observer. Hence, the use of antibody to parvovirus B19 may be useful in establishing the diagnosis. Therefore, a high index of suspicion when assessing bone marrow smears/biopsies in patients with chronic severe anemia in the immunocompromised will alert the observer to the possibility of parvovirus infection. Although Liu et al found antiparvovirus B19 antibody to be less sensitive than in situ hybridization (ISH), others have not made the same observation. Investigating fatal non-immune hydrops fetalis, Morey et al (1992) found good correlation between R92F6 antibody staining and B19 DNA in 19 cases. Further, these workers demonstrated the virus with immunohistochemistry (and ISH) in two cases that lacked parvovirus B19 inclusions on H&E stains indicating that low-grade or resolving infections may be missed on simple morphological examination alone.
Comments
Parvovirus B19 infection should be considered in any unexplained chronic persistent anemia in an immunocompromised patient.
References
•Brown KE, Anderson SM, Young NS 1993 Erythrocyte P antigen: cellular receptor of B19 parvovirus. Science 262: 114-117.
•Cossart YE, Fiedl AM, Cant B et al 1975 Parvovirus-like particles in human sera. Lancet 1: 72-73.
•Liu W, Ittmann MD, Liu J et al 1997. Human parvovirus B19 in bone marrows from adults with acquired immunodeficiency syndrome: a comparative study using in situ hybridization and immunohistochemistry. Human Pathology 28: 760-766.
•Morey AL, O'Neill HJ, Coyle PV et al 1992 Immunohistological detection of human parvovirus B19 in formalin fixed paraffin embedded tissues. Journal of Pathology 166: 105-108.
•Mortimer PP, Humphries RK, Moore JG et al 1983 A human parvovirus-like virus inhibits hematopoietic colony formation in vitro. Nature 302: 426-429.
Bibliografía
Manual of diagnostic antibodies for immunohistology / Anthony S.-Y. Leong, Kumarasen Cooper, F. Joel W.-M. Leong.
Chemicon, Dako (polyclonal), Novocastra (R92F6) and Vector Laboratories (R92F6).
Fixation/Preparation
Applicable to archival formalin-fixed paraffin-embedded tissue sections. Before immunostaining, sections should be subjected to heat-induced epitope retrieval buffer at 100 C for 20 min (Liu et al, 1997).
Background
Human parvovirus B19 was accidentally discovered in 1975 in human serum being screened for hepatitis B surface antigen (Cossart et al, 1975). Since discovery, this virus has been found to be the causative agent in erythema infectiosum, chronic anemia in immunosuppressed patients, fetal death associated with hydrops and acute arthralgia/arthritis in adults (Liu et al, 1997).
Parvovirus B19, which is cytotoxic to erythroid progenitor cells in vivo and in vitro, enters the erythroid precursor cell via the blood group P antigen (Mortimer et al, 1983; Brown et al, 1993). In the past several years, human parvovirus B19 has been reported as a cause of severe and persistent anemia in patients immunocompromised from organ transplantation, autoimmune disease, hematologic malignancies, chemotherapy and congenital or acquired immunodeficiency states including HIV infection (Liu et al, 1997).
The R92F6 monoclonal antibody is directed against the VP1 and VP2 capsid protein of parvovirus B19.
Applications
On bone marrow smears and trephine biopsies, finding the giant erythroblast and small erythroid precursors with nuclear inclusions (lantern cells) establishes the diagnosis. However, these cells may easily be overlooked by the inexperienced observer. Hence, the use of antibody to parvovirus B19 may be useful in establishing the diagnosis. Therefore, a high index of suspicion when assessing bone marrow smears/biopsies in patients with chronic severe anemia in the immunocompromised will alert the observer to the possibility of parvovirus infection. Although Liu et al found antiparvovirus B19 antibody to be less sensitive than in situ hybridization (ISH), others have not made the same observation. Investigating fatal non-immune hydrops fetalis, Morey et al (1992) found good correlation between R92F6 antibody staining and B19 DNA in 19 cases. Further, these workers demonstrated the virus with immunohistochemistry (and ISH) in two cases that lacked parvovirus B19 inclusions on H&E stains indicating that low-grade or resolving infections may be missed on simple morphological examination alone.
Comments
Parvovirus B19 infection should be considered in any unexplained chronic persistent anemia in an immunocompromised patient.
References
•Brown KE, Anderson SM, Young NS 1993 Erythrocyte P antigen: cellular receptor of B19 parvovirus. Science 262: 114-117.
•Cossart YE, Fiedl AM, Cant B et al 1975 Parvovirus-like particles in human sera. Lancet 1: 72-73.
•Liu W, Ittmann MD, Liu J et al 1997. Human parvovirus B19 in bone marrows from adults with acquired immunodeficiency syndrome: a comparative study using in situ hybridization and immunohistochemistry. Human Pathology 28: 760-766.
•Morey AL, O'Neill HJ, Coyle PV et al 1992 Immunohistological detection of human parvovirus B19 in formalin fixed paraffin embedded tissues. Journal of Pathology 166: 105-108.
•Mortimer PP, Humphries RK, Moore JG et al 1983 A human parvovirus-like virus inhibits hematopoietic colony formation in vitro. Nature 302: 426-429.
Bibliografía
Manual of diagnostic antibodies for immunohistology / Anthony S.-Y. Leong, Kumarasen Cooper, F. Joel W.-M. Leong.
