Fetal Parvovirus B19 Infection and Liver Disease of Antenatal Onset in an Infant with Ebstien's Anomaly

Abstract

Fetal parvovirus B19 infection has been reported in association with hydrops and fetal demise, myocarditis, and congenital anomalies, as well as with normal outcome of pregnancy. One infant with liver disease of fetal onset associated with parvovirus B19 infection has been described. We have seen another such infant, in whom marked siderosis of the liver suggested accelerated destruction of erythrocytes and portal tract fibrosis with proliferation of bile ducts suggested intrauterine infection. Viral cytopathic effects were not seen. Maternal serum obtained postpartum contained IgM clas antibodies against parvovirus B19, and parvovirus B19 nucleic acid sequences were identified in the infant's liver by polymerase chain reaction studies. We propose that recognition of this combination of siderosis with fibrosis and bile duct proliferation will permit identification of cases of fetal parvovirus B19 infection.

Key Words:

• bile ducts
• fetus
• infection
• liver disease
• parvovirus B19
• polymerase chain reaction