Clinical illness due to parvovirus B19 infection after infusion of solvent/detergent‐treated pooled plasma

• Published in: Transfusion (Philadelphia, Pa.) Pa.), 2000-10, Vol.40 (10), p.1203-1206
• Main Authors: Koenigbauer, Ulrike F., Eastlund, Ted, Day, John W.
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Detergents - pharmacology; Female; Humans; IMIG = IM immune globulin; INR = international normalized ratio; IVIG = IV immune globulin; Medical sciences; Parvoviridae Infections - etiology; Parvovirus B19, Human; Plasma - drug effects; Plasma Exchange - adverse effects; S/D plasma = solvent/detergent‐treated pooled plasma; S:CO = signal‐to‐cutoff; Solvents - pharmacology; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1046/j.1537-2995.2000.40101203.x

BACKGROUND: Lipid‐enveloped viruses such as HIV, HBV, and HCV can be inactivated by treatment with solvents and detergents. HAV and human parvovirus B19 lack lipid envelopes and are not inactivated. Solvent/detergent‐treated pooled plasma (S/D plasma) contains neutralizing antibodies, but it is not known whether the parvovirus B19 antibody content is sufficient to prevent transmission of the disease. A patient is described who developed a clinical illness due to parvovirus B19 infection after the infusion of S/D plasma. CASE REPORT: A 36‐year‐old woman with myasthenia gravis underwent five plasma exchange procedures from January 15 to January 25, 1999, using albumin, except for 5 units of SD plasma given because of a low fibrinogen level. Four of the 5 units were implicated in a recall after high levels of parvovirus B19 DNA were found in several lots. Two weeks after the infusion, the patient developed fatigue, a rash, and severe polyarthralgias. Parvovirus B19 IgG and IgM antibody titers were consistent with an apos infection. CONCLUSION: Clinically apparent parvovirus B19 infection can follow the use of S/D plasma that contains high levels of parvovirus B19 DNA.