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Parvovirus B19 IgM Antibody by EIA - Serum

Anemia
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No Fasting Required

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Detects antibodies.

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Parvovirus B19 IgM Antibody by EIA - Serum

  • Why is it done?
    • Test Purpose: Detects IgM antibodies against Parvovirus B19, indicating acute or recent infection with human parvovirus B19 (erythrovirus)
    • Primary Indications: Diagnosis of acute parvovirus B19 infection in patients presenting with symptoms such as erythematous rash ("slapped cheek" appearance in children), arthralgia, arthritis, fever, and malaise
    • Clinical Scenarios: Evaluation of fifth disease (erythema infectiosum) in children, polyarthropathy/arthritis syndrome (especially in women), hemolytic anemia exacerbation in immunocompromised patients, investigation of fetal hydrops or intrauterine complications in pregnant women, and acute arthritis of unknown etiology
    • Typical Timing: Usually performed during the early phase of illness (first 1-2 weeks of symptoms), when patients present with clinical symptoms suggestive of parvovirus B19 infection
  • Normal Range
    • Reference Values: Negative or <0.90 Index (specific values may vary by laboratory). Some laboratories report as "Non-Reactive" or "Negative"
    • Units of Measurement: Index value (typically 0.00-1.00 range for negative; >1.10 for positive) or Qualitative (Reactive/Non-Reactive), depending on assay methodology
    • Negative Result: No detectable IgM antibodies to parvovirus B19; rules out acute infection or indicates infection is beyond the IgM phase (generally after 2-3 months)
    • Positive Result: IgM antibodies detected; indicates acute or recent parvovirus B19 infection
    • Borderline/Equivocal Results: Index values 0.90-1.10 may be reported as "Inconclusive" and may require repeat testing after 1-2 weeks or correlation with clinical presentation and IgG results
    • Normal Interpretation: A negative IgM result indicates either no acute parvovirus B19 infection or recovery from infection beyond the typical 2-3 month IgM window
  • Interpretation
    • IgM Positive Result: Indicates acute or very recent parvovirus B19 infection (typically within 1-2 weeks to 2-3 months of symptom onset). Patient is likely in the acute phase and may be contagious
    • IgM Negative Result: Suggests either no active parvovirus B19 infection, infection is beyond the IgM phase (past 2-3 months), or negative result obtained during incubation period before IgM appears. If clinical suspicion remains high, consider repeat testing after 1-2 weeks or check IgG status
    • Clinical Correlation: Results must be interpreted in context of clinical presentation. A positive IgM with typical "slapped cheek" rash in a child, or polyarthralgia/arthritis in an adult, especially women, strongly supports acute parvovirus B19 infection diagnosis
    • Factors Affecting Results: Timing of test (IgM appears 2-3 days after symptom onset and persists for 2-3 months); immunocompromised status (may show reduced or absent IgM response); specimen handling and storage; individual immune response variation; cross-reactivity with other parvoviruses is minimal with modern EIA assays
    • Clinical Significance: A positive IgM helps establish acute parvovirus B19 as the cause of illness, guiding patient management and transmission precautions. In pregnant women, positive IgM may warrant additional fetal monitoring. In immunocompromised patients, positive IgM confirms diagnosis of opportunistic infection requiring specific management
    • IgM and IgG Combined Interpretation: IgM positive + IgG negative = acute/very recent infection; IgM positive + IgG positive = acute infection in context of prior exposure; IgM negative + IgG positive = past infection with immunity; IgM negative + IgG negative = no immunity or infection not yet in antibody phase
  • Associated Organs
    • Primary Organ Systems Affected: Skin (erythematous rash), joints and connective tissue (arthralgias and arthritis), bone marrow (erythroid progenitor cell destruction), cardiovascular system (myocarditis risk), and hematopoietic system (transient erythropenia)
    • Conditions Associated with Abnormal Results: Fifth disease (erythema infectiosum), symmetric polyarthritis/polyarthralgia syndrome, acute onset arthritis, anemia with reticulocytopenia, myocarditis, thrombocytopenia, and in immunocompromised patients, chronic anemia and pure red cell aplasia
    • Diseases Diagnosed or Monitored: Acute parvovirus B19 infection (erythrovirus), with particular relevance in: children presenting with characteristic rash; women with arthritis (more common than in men); immunocompromised patients (HIV/AIDS, organ transplant recipients, chemotherapy patients); pregnant women with risk of fetal complications; patients with chronic hemolytic anemias (sickle cell disease, hereditary spherocytosis)
    • Complications Associated with Infection: Severe anemia requiring transfusion (particularly in hemolytic disease patients), hydrops fetalis and intrauterine fetal death (1-5% of infected pregnancies), chronic anemia in immunocompromised hosts, acute myocarditis, meningoencephalitis (rare), and disseminated disease in severely immunocompromised patients
    • Bone Marrow Impact: Virus specifically targets erythroid progenitor cells (CFU-E and BFU-E), resulting in transient halt of red blood cell production; in patients with baseline hemolytic anemia, this causes acute severe anemia (transient aplastic crisis)
    • Pregnancy Considerations: Positive maternal IgM indicates potential fetal risk, particularly in first and second trimester; can lead to fetal anemia, heart failure, and hydrops fetalis; requires additional fetal assessment and monitoring
  • Follow-up Tests
    • Parvovirus B19 IgG Antibody Testing: Recommended in all cases with positive IgM to confirm immune status and assess for prior infection; IgG positivity with negative IgM suggests past immunity; can be used to establish baseline immunity in susceptible populations
    • Parvovirus B19 PCR/Nucleic Acid Testing (NAT): Useful if IgM negative but clinical suspicion high (testing too early in illness); particularly valuable in immunocompromised patients who may not mount adequate IgM response; can detect viral DNA in serum and tissue specimens
    • Complete Blood Count (CBC): Assess for anemia, reticulocytopenia, and thrombocytopenia; particularly important in immunocompromised patients and those with chronic hemolytic anemias; monitor for transient aplastic crisis
    • Reticulocyte Count: Recommended in positive IgM cases to detect transient erythroid aplasia; low reticulocyte count with anemia in setting of positive parvovirus serology confirms transient aplastic crisis diagnosis
    • Fetal Ultrasound/Non-Stress Testing: Essential follow-up for positive maternal IgM in pregnant women; assess for signs of hydrops fetalis, cardiomegaly, and pericardial effusion; serial ultrasounds may be needed to monitor fetal condition
    • Liver Function Tests (LFTs): May be indicated in severely ill patients to assess for hepatic involvement; parvovirus can occasionally cause transient hepatitis
    • Cardiac Assessment (ECG/Echocardiography): Consider if patient has chest pain, dyspnea, or signs of heart failure; parvovirus can cause myocarditis, though rare
    • Repeat Serological Testing: If initial IgM is negative/equivocal but clinical suspicion remains high, repeat testing after 1-2 weeks to detect seroconversion; especially recommended when testing performed during prodromal phase before IgM development
    • Monitoring Frequency for Chronic Cases: In immunocompromised patients with chronic parvovirus infection, periodic CBC and PCR monitoring recommended to assess viral burden and anemia progression; pregnant women with confirmed infection require regular fetal assessment; patients with hemolytic disease need CBC monitoring during acute illness phase
  • Fasting Required?
    • Fasting Status: No
    • Fasting Duration: Not applicable - fasting is not required for this serological test
    • Dietary Instructions: No dietary restrictions; normal diet and fluid intake are permitted before testing
    • Medications: No medications need to be withheld or avoided for this test; continue all regularly prescribed medications as directed
    • Patient Preparation Requirements: Minimal preparation needed; standard venipuncture procedure for serum collection; patient identification verification required; inform phlebotomist of any bleeding disorders or anticoagulation therapy (does not affect test but ensures safe blood draw); collection can be performed at any time of day; no need for special timing relative to meals
    • Specimen Type: Serum (5-10 mL collected in serum separator tube); specimen should be allowed to clot before centrifugation
    • Specimen Handling: Keep specimen at room temperature for transport; do not refrigerate before separation; refrigerate after separation or freeze if delayed testing; label with patient name, date of birth, date/time of collection, and accession number

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