Tuesday, July 28, 2009

Parvovirus B19 and Rheumatoid Arthritis: Who is the real fraud?

Does human parvovirus B19 Cause Rheumatoid Arthritis?

There is a counterfeit Rheumatoid Arthritis. But it is only a pretender, so it doesn’t inflict the harm that RA does. It is like a shadow boxer. However, the pain is real – for as long as it lasts.

Human parvovirus B19 is a common childhood virus. It causes Fifth disease, a minor childhood disease which is similar to the measles. There are usually cold symptoms and a low grade fever. There is often a rash on the face which is bright red. It is called “slapped cheek.” But, it’s often so not simple in adult women.

Parvovirus often mimics Rheumatoid Arthritis, causing pain, stiffness, swelling, and disability. Approximately 60% of women who get B19 contract the sudden arthritis in multiple joints. However, children and men who are infected with parvovirus do not usually suffer from such arthralgia.

Normally, joint symptoms last only a couple of weeks. However, in a small percentage of patients, they may last for several weeks to several months. There is also initially a distinctive rash on the trunk and limbs which looks a lot like lace.

Several studies have been done to investigate whether parvovirus B19 is in any way connected with actual Rheumatoid Arthritis. However, they have concluded that it probably is not.

Consider this: the percentage of people who have the B19 antibody (showing they have had the virus) is about 50%. Similar numbers have been shown for Rheumatoid Arthritis patients. If B19 were the cause of Rheumatoid Arthritis, 100% of RA patients would have had the virus.

Studies continue to examine whether parvovirus B19 could be one trigger for Rheumatoid Arthritis. Also, B19 may behave differently in people who have RA. It could be one of those “chicken and egg” questions.

Double Déjà Vu

Researchers say they don’t know what causes human parvovirus, but I met a doctor once who says he does know. In 1998, when my family contracted the disease, I went to an urgent care center on a Sunday. Every joint, especially my cervical spine, was inflamed. I could barely move. I had no idea what was wrong with me. I was terrified. The lacey red rash covered my legs.

The doctor took one look at me and he knew what was wrong. I guess it was too traumatic to tell me to my face since he decided to tell my husband first. He said he was sure he was right.

He told my husband that my joint pain was nothing to worry about. It was caused by my imagination. Yep. Simple as that. And the rash? He looked right at it and said that it did not exist. Whew! According to him, I was not sick; I was a fraud.

Double déjà vu: I wish I could report that he was the worst doctor I have ever met. Unfortunately, though, I have been through the exact same process a few times with regard to Rheumatoid Arthritis. It has been a double déjà vu. First, with the arthritis symptoms; and then, with the “hysterical woman” diagnosis.

Postscript: It was a classic case of parvovirus.

I did take my kids to the pediatrician the following week when they developed the classic B19 symptom of “slapped cheek” rash. My kids were easily diagnosed with the highly contagious “fifth disease” which is caused by human parvovirus. The docs got all excited about how closely our case replicated the photographs in their books.

More information on human parvovirus B19:

More Rheumatoid Arthritis Warrior:


Jenny said...

Very interesting, Kelly! I commented in a post not too long ago that I was infected by Fifth's about 10 or so years ago. The interesting thing that I didn't tell you is that I have an identical twin sister who had it first (about a month before I did). Her diagnosis helped me tell the doctor what to test for...he looked at me like I was an idiot and also looked carefully at the rash on my legs and said he didn't see it (obviously he was used to looking at very old, blotchy skin and didn't think mine was unusual). He could not ignore the stiffness and swelling. It was a very scary thing for me as I felt like I was elderly and I was only in my 20's. When I went back for his diagnosis, he acted like he was surprised with his findings. All that to say, my hands have never been the same. Achy and stiff for the past 10 years but just now a positive diagnosis of RA. My sister does not have RA but does take Celebrex on a regular basis for inflammation. The parallel is just weird and I still wonder if there is a connection.

Interestingly, after that Fifths diagnosis I received a call from a lab in California (I live in Alabama)asking for a pint of my blood for testing. They paid me $500 for it! I always called it my "blood money". I guess that sum would only be a drop in the bucket compared to the money drug companies would make if they found a cure. :-)

Kelly said...

Jenny! You and your twin sister should be in a study somewhere! I hope she never gets the RA.

Did you feel like he was trying to give you the "hysterical woman" diagnosis? Sounds like maybe. I still want my money back from my fifth disease. The guy charged us $100 for the "crazy" diagnosis - I did not have insurance and would not have gone to be seen except that I was afraid. Duh.

Sure wish I could get some money for all the blood I let now. Hahaha.

Jenny said...

My answer is "yes" for the hysterical diagnosis..that doctor had the personality and bedside manner of a walking dead person. I was afraid, too....I wanted relief from the pain but by the time I got that diagnosis I was much better. UGHH!
My sister was jealous of my blood money. She always thought we should split it! HA! BTW...we didn't!
I do think a twin study would be quite interesting...maybe one day.

Michelle said...

Hi Kelly! I found your blog through the Buckle Me Up Movement and have enjoyed reading about your experiences. I was diagnosed with RA in the fall of 2008 at the age of 29. I am still coming to grips with it all and am in the "research phase" of coping with this disease. I had a severe case of fifth's disease as a child, and the more I read, I can't help wondering if there is a connection between these diseases. Thanks for putting the information out there!
Best, Michelle Charles

Kelly said...

Hi Michelle! Welcome!
Very curious: usually it is so mild for kids. What happened to you when you had it? For me, it was just like RA. But I was over 30. My kids were fine - just had a rash.

By the way, my good friend kinda "gets" my RA to a point since she had the fifth disease. It showed her what it is like.

nygiantsfanatic said...

Once again, Kelly, you're mading me think. I don't normally think this much on summer vacation :0)

My son had Fifth's disease a couple of years ago. He had no joint pain or anything. Just the fever and facial rash.

But 10 years ago or so, I contracted strep. It went ignored for 3 days by the docs because I didn't have any white spots on my throat. They told me it was just a really bad sore throat. Then later when they finally decided I had strep, I got pennicillin. I ended up having what the docs finally ruled as an allergic reaction to pennicillin.

But after reading this, not only did I have all the symptoms of an allergic reation to a drug, but it seems I also had all the symptoms of fifth's. They seem pretty much the same. Swollen joints, rash, fever.

Now you got me wondering. Was that all just another wrong diagnosis? Many of us have wondered it before....how long did we really have RA before we were finally diagnosed?

Kelly said...

someday, we'll get the research and maybe we'll know.

DREAMING: Wouldn't it be great to get a diagnosis and a shot at day one and be done with it?

Happy vacation, giantsfan!

Julie Lydell said...

Yup and your good friend was diagnosed by the kids' pediatrician not the high priced doctor who put her through a bunch of tests then had his pregnant!!! nurse take her blood for more! Hmmm...???

Love you!

Kelly said...

Yes, only the pediatrician believed / diagnosed me, too .

Julie, since you are such a good friend, I do know that while you do NOT have RA yourself, you try very hard to understand. So, the following comment is for the benefit of others who may doubt us:

IMAGINE you had to go through the rest of your life with with that pain that you had during the parvovirus AND the added benefit of repeatedly being doubted as many of us were by the doctor. That is often the story of RA.