Parvovirus B19 Immunoglobulin G and Immunoglobulin M Antibodies

Parvovirus B19 Immunoglobulin G and Immunoglobulin M Antibodies

Synonym/acronym: N/A.

Common use

To assist in confirming a diagnosis of a present or past parvovirus infection.

Specimen

Serum (2 mL) collected in a gold-, red-, or red/gray-top tube. Place separated serum into a standard transport tube within 2 hr of collection.

Normal findings

(Method: Immunoassay)
NegativeLess than 0.8 index
Equivocal0.8–1.2 index

Description

Parvovirus B19, a single-stranded DNA virus transmitted by respiratory secretions, is the only parvovirus known to infect humans. Parvovirus B19 can also be transmitted in infected blood products and across the placental barrier to the fetus. Its primary site of replication is in red blood cell precursors in the bone marrow. It is capable of causing disease along a wide spectrum ranging from a self-limited erythema (fifth disease) to bone marrow failure or aplastic crisis in patients with sickle cell anemia, spherocytosis, or thalassemia. Fetal hydrops and spontaneous abortion may also occur as a result of infection during pregnancy. The incubation period is approximately 1 wk after exposure. The infection is more common in children than adults. B19-specific antibodies appear in the serum approximately 3 days after the onset of symptoms. The presence of immunoglobulin M (IgM) antibodies indicates acute infection. The presence of immunoglobulin G (IgG) antibodies indicates past infection and is believed to confer lifelong immunity. Parvovirus B19 can also be detected by DNA hybridization using a polymerase chain reaction (PCR) method.

This procedure is contraindicated for

    N/A

Indications

  • Assist in establishing a diagnosis of parvovirus B19 infection

Potential diagnosis

Positive findings in:

  • Parvovirus infection can be evidenced in a variety of conditions.

  • Arthritis
  • Erythema infectiosum (fifth disease)
  • Erythrocyte aplasia
  • Hydrops fetalis
N/A

Critical findings

    N/A

Interfering factors

  • Immunocompromised patients may not develop sufficient antibody to be detected.

Nursing Implications and Procedure

Pretest

  • Positively identify the patient using at least two unique identifiers before providing care, treatment, or services.
  • Patient Teaching: Inform the patient this test can assist in diagnosing a viral infection.
  • Obtain a history of the patient’s complaints, including a list of known allergens, especially allergies or sensitivities to latex.
  • Obtain a history of the patient’s immune system, symptoms, and results of previously performed laboratory tests and diagnostic and surgical procedures.
  • Obtain a list of the patient’s current medications, including herbs, nutritional supplements, and nutraceuticals (see Effects of Natural Products on Laboratory Values).
  • Review the procedure with the patient. Inform the patient that specimen collection takes approximately 5 to 10 min. Inform the patient that a subsequent sample will be required in 7 to 14 days. Address concerns about pain and explain that there may be some discomfort during the venipuncture.
  • Sensitivity to social and cultural issues, as well as concern for modesty, is important in providing psychological support before, during, and after the procedure.
  • Note that there are no food, fluid, or medication restrictions unless by medical direction.

Intratest

  • Potential complications: N/A
  • Avoid the use of equipment containing latex if the patient has a history of allergic reaction to latex.
  • Instruct the patient to cooperate fully and to follow directions. Direct the patient to breathe normally and to avoid unnecessary movement.
  • Observe standard precautions, and follow the general guidelines in Patient Preparation and Specimen Collection. Positively identify the patient, and label the appropriate specimen container with the corresponding patient demographics, initials of the person collecting the specimen, date, and time of collection. Perform a venipuncture.
  • Remove the needle and apply direct pressure with dry gauze to stop bleeding. Observe/assess venipuncture site for bleeding or hematoma formation and secure gauze with adhesive bandage.
  • Promptly transport the specimen to the laboratory for processing and analysis.

Post-Test

  • Inform the patient that a report of the results will be made available to the requesting health-care provider (HCP), who will discuss the results with the patient.
  • Recognize anxiety related to test results, and be supportive of impaired activity related to lack of neuromuscular control, perceived loss of independence, and fear of shortened life expectancy. Discuss the implications of abnormal test results on the patient’s lifestyle. Provide teaching and information regarding the clinical implications of the test results, as appropriate. Educate the patient regarding access to counseling services.
  • Reinforce information given by the patient’s HCP regarding further testing, treatment, or referral to another HCP. Emphasize the need for the patient to return to have a convalescent blood sample taken in 7 to 14 days. Answer any questions or address any concerns voiced by the patient or family.
  • Depending on the results of this procedure, additional testing may be performed to evaluate or monitor progression of the disease process and determine the need for a change in therapy. Evaluate test results in relation to the patient’s symptoms and other tests performed.

Related Monographs

  • Related tests include CBC, CBC RBC morphology, and CBC WBC count and differential.
  • Refer to the Immune System table at the end of the book for related tests by body system.
Handbook of Laboratory and Diagnostic Tests, © 2013 Farlex and Partners