A Parsonage-Turner Syndrome secondary to Parvovirus B19 infection

A Parsonage-Turner Syndrome secondary to Parvovirus B19 infection


  • Flavio Mozzani Azienda Ospedaliero-Universitaria di Parma
  • Noemi Giuliana Marino Azienda Ospedaliero-Universitaria di Parma
  • Andrea Becciolini Azienda Ospedaliero-Universitaria di Parma
  • Eleonora Di Donato Azienda Ospedaliero-Universitaria di Parma
  • Alarico Ariani Azienda Ospedaliero-Universitaria di Parma
  • Daniele Santilli Azienda Ospedaliero-Universitaria di Parma


Parvovirus B19, Parsonage-Turner Syndrome


Parvovirus B19 (PVB19) is a small DNA virus that causes the fifth disease in children; however it can also affect adults. The infection can be asymptomatic in about a quarter of healthy subjects. Typical clinical manifestations are: short lived fever accompanied by asthenia, myalgias and pharyngodynia; symmetrical acute polyarthritis; megalo-erytema in child; maculopulotic rash and/or fleeting purpuric at the extremities in adult; adenopathies in the cervical area. Atypical manifestions can affect neurological system (both central and peripheral), hearth and kidney. We describe a 37-year-old man with neuralgic amyotrophy (Parsonage-Turner syndrome) caused by Parvovirus B19 infection.

Author Biographies

Flavio Mozzani, Azienda Ospedaliero-Universitaria di Parma

Department of Medicine, Internal Medicine and Rheumatology Unit

Noemi Giuliana Marino, Azienda Ospedaliero-Universitaria di Parma

Department of Medicine, Internal Medicine and Rheumatology Unit

Andrea Becciolini, Azienda Ospedaliero-Universitaria di Parma

Department of Medicine, Internal Medicine and Rheumatology Unit

Eleonora Di Donato, Azienda Ospedaliero-Universitaria di Parma

Department of Medicine, Internal Medicine and Rheumatology Unit

Alarico Ariani, Azienda Ospedaliero-Universitaria di Parma

Department of Medicine, Internal Medicine and Rheumatology Unit

Daniele Santilli, Azienda Ospedaliero-Universitaria di Parma

 Department of Medicine, Internal Medicine and Rheumatology Unit


P.Sève et al. Manifestations systèmique des infections à Parvovirus B19.La revue de mèdecine interne 25(2004) 740-751

Bultmann BD, Klingel K, Sotlar K, Bock T, Kandolf R, Parvovirus B19: a pathogen responsible for more than hematologic disorders Virchows Arch 2003;442:8-17

Modrow S, Dorsch S. Antibody responses in parvovirus B19 infected patients. Pathol Biol (Paris 2002; 50:326-31

Labau E, Bonnet E, Alric L, Massip P, Infection par le Parvovirus B19 Nouvelles approches phsiopathologiques. Presse Med 1996; 25:162-6

Karmochkine M, Infection humaine par le Parvovirus B19. Rev Mèd Interne 1995; 16:905-12

Hayakawa H, Tara M, Niina K, Osame M. A clinical study of adult human parvovirus B19 infection. Intern Med 2002; 41:259-9

Kerr JR, Coyle PV, DeLeys RJ, Patterson CC. Follow-up study of clinical and immulogical findings in patients presenting with acute Parvovirus B19 infection,

J Med Virol 1996; 48:68-75

Woolf AD,Campion GV, Chishick A, Wise S, Cohen BJ, Klouda PT, et al Clinical manifestations of human parvovirus B19 in adults. Arch Intern Med 1989; 149: 1153-6

Oiwa H, Shimada T,Hashimoto M, Kawaguchi A, Ueda T, Sugiyama E, et al. Clinical findings in parvovirus B19 infection in 30 adult patients in Kyoto. Mod Rheumatol 2011; 21:24-31

Waza K, Inoue K, Matsumura S, Symptoms associated with parvovirus B19 infection in adults: a pilot study Intern Med 2007; 46:1975-8

Varache S, Narbonne V, Jousse-Joulin S, Guennoc X, Dougados M, Daurès JP, et al Is routine viral screening useful in patients with recent-onset polyarthritis of a duration of at least 6 weeks? Result from a nationwide longitudinal prospective cohort study Arthritis Care Res 2011; 63: 1565-70

Moore TL. Parvovirus-associated arthritis. Curr Opinion Rheumatol 2000; 12: 289-94

Vassilopoulos D, Calabrese LH. Viraly associated arthritis: clinical epidemiologic and pathophysiologic considerations Arthritis Res Ther 2008 ; 10:215.

Hashimoto H, Yuno T. Parvovirus B19-associated purpuric-petechial eruption J Clin Virol 2011; 52: 268-71

Douvoyiannis M, Litman N, Goldman DL. Neurologic manifestations associated with parvovirus B19 infection. Clin Infect Dis 2009; 48:1713-23

Lenglet T, Haroche J, Schnuriger A, Maisonobe T, Viala K, Michel Y, et al Mononeuropathy multiplex associated with acute parvovirus B19 infection: characteristics, treatment and outcome. J Neurol 2011; 258:1321-6

Scheibe F, Hofmann J, Ruprecht K, Parainfectious myelitis associated with parvovirus B19infection. J Neurol 2010; 257:1557-8

Rabar D, Peyramond D. Dysesthèsies prolongèes rèvèlant une primo-infection à Parvovirus B19. Med Mal Infect 2005; 35: 91-4

Le Scanff J, Vighetto A, Mekki Y, Nguyen AM, Dufour JF, Broussolle C, et al. Acute ophthalmoparesis associated with human parvovirus B19 infection. Eur J Ophthalmol 2010;20: 802-4

Dennert R, Crijns HJ, Heymans S. Acute viral myocarditis. Eur Heart J 2008;29:2073-82

Trochu JN, Piriou N, Toquet C, Bressollette C, Valleix F, Le Tourneau T, et al. Myocardites. Rev Med Interne 2012; 33: 567-74

Basic D, Gupta S, Kwong RY. Parvovirus B19-induceded myocarditis mimicking acute myocardial infarction: clarification of diagnosis by cardiac magnetic resonance imaging. Circulation 2010;121: 40-2

Bock CT,Klingel K, Kandolf R. Human parvovirus B19-associated myocarditis. N Engl J Med 2010;362: 1248-9

Stewart GC, Lopez-Molina J, Gottumukkala RVSRK, Rosner GF, Anello MS, Hecht JL, et al. Myocardial parvovirus B19 persistence: lack of association with clinico-pathologic phenotype in adults with heart failure. Circ Heart Fail 2011;4:71-8

Waldman M, Kopp JB. Parvovirus B19 and the Kidney. Clin Jam Soc Nephhrol 2007 ;2 (suppl 1):47-56

Magy L. Neuropathies pèripheriques: dèmarche diagnostique. La Revue de mèdicine interne 39(2018) 27-33

Parsonage MJ, Turner AJW. Neuralgic amyotrophy, the shoulder girdle syndrome.Lancet 1948; 254 : 973-8

Van Alfen N, Van Engelen BG. The clinical spectrum of neuralgic amyotrophy in 246 cases. Brain 2006; 129: 438-50

Van Alfen N, Van Eijk jj, Ennik t, et al. Incidence of neuralgic amyotrophy(Parsonage-Turner syndrome) in a primary care setting-a prospective cohort study. Plos One 2015; 10: eO128361

MacDonald BK, Cockerell OC, Sander JW et al. The incidence and lifetime prevalence of neurological disorders in a prospective community-based study in the UK. Brain 2000; 123:665-76

Cruz-Martinez A, Barrio M, Arpa J. Neuralgic amyotrophy:variable expression in 40 patients. J Peripher Nerv Syst 2002; 7: 198-204

Denning DW, Amos A, Rudge P, Cohen BJ. Neuralgic amyotrophy due to parvovirus infection, J Neurol Neurosurg Psychiatry, 1987, vol.50 641-2

Walsh KJ, Amstrong RD,Turner AM. Brachial plexus neuropathy associated with human parvovirus infection, Br Med J Clin ReS Ed, 1988 vol 296 896

Faden H, Gary GWJr, Anderson LJ. Chronic parvovirus infection in a presumably immunologically healthy woman, Clin Infect Dis, 1992, vol15 595-7

Maas JJ, Beersma MF, Haan J, Jonkers GJ, Kroes AC. Bilateral brachial plexus neuritis following parvovirus B19 and cytomegalovirus infection, Ann Neurol, 1996, vol 40 928-32

Puechal X, Hilliquin P, Kahan A, Menkes CJ. Neuralgic amyotrophy and polyarthritis caused by parvovirus B19 infection, Ann Rheum Dis , 1998 57, 262

Van Alfen N, Huisman WJ, Overeem S, et al. Sensory nerve conduction studies in neuralgic amyotrophy. Am J Phys Med Rehabil 2009;88: 941-6

Beghi E, Kurland LT, Mulder DW, et al. Brachial plexus neuropathy in the population of Rochester. Minnesota 1970-1981. Ann Neurol 1985; 18: 320-3

Winer JB, Hughes RA, Anderson MJ, et al. A prospective study of acute idiopathic neuropatthy. II. Antecedent events. J Neurol Neurosurg Psychiatry 1998;51:613-8

Pham M,Baumer P, Meinck HM, et al. Anterior interosseus nerve syndrome fascicular motor lesions of median nerve trunk. Neurology 2014; 82:598-606

Gaskin CM, Helms CA. Parsonage-Turner syndrome: MR imaging findings and clinical information of 27 patients. Radiology 2006; 240:501-7

Pan Y, Wang S, Zheng D, et al. Hourglass-like constrictions of peripheral nerve in the upper extremity: a clical review anda pathological study. Neurosurgery 2014; 75:10-22

Van Eijk JJ, Van Allen N, Berrevoets M, et al. Evaluation of prednisolone treatment in the acute phase of neuralgic amyotrophy: an observational study . J Neurol Neurosurg Psychiatry 2009;80:1120-4

Johnson NE, Petraglia AL, Huang JH et al. Rapid resolution of severe neuralgic amyotrophy after treatment with corticosteroids anda intravenous immunoglobulin. Muscle Nerve 2011;44: 304-5

Naito KS, Fukushima K, Suzuki S et al. Intravenous immunoglobulin (IVg)with methylprednisolone pulse therapy for motor impairment of neuralgic amyotrophy:clinical observations in 10 cases. Intern Med 2012;26: 841-4






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How to Cite

A Parsonage-Turner Syndrome secondary to Parvovirus B19 infection. Acta Biomed [Internet]. 2021 Apr. 30 [cited 2024 May 30];92(S1):e2021129. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/10702

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