More virus stuff...

[JAMESFETT]

So many interesting reports coming out about viral heart disease/cardiomyopathy, especially with respect to Parvovirus B19. Emphasizes the importance of studying IgM and IgG antibodies in the blood, as well as viral particles by PCR testing in the blood. There are some astounding new things coming along. I believe they will also apply to PPCM. Stay tuned.....

JD

[Stephanie'sbigheart]

Dr. Fett thank you for keeping us in the loop! I am looking forward to all the new details. I swear you are the best person ever! Every time I sign on and see a women who was just DX. you are as sweet to them as you were with me. Even when we ask the SAME questions over and over. I would love to one day shake your hand and give you a hug!

Thank you for being you!

love,

Stephanie

[momof3nc]

Dr. Fett,
In August when I was at 25 weeks gestation my 18 month old was diagnosed with parvovirus. I actually started having worse palpatations around that time. I went to my OB and was tested for exposure. My IgG was 2.8. At 27 weeks I was admited for chest pain, SOB, and tachycardia. Thats when I found out my LVEF was 45%. I told the staff and cardiologist at the hospital and was told it was not related. I changed my OB and had IgM drawn several weeks later which was told I was negative for exposure (not sure of lab value). Do you think it was related? If so does that change my treatment and outcome of recovery?

[JAMESFETT]

That's an important piece of information, and it is fortunate that your exposure to PVB19 did not occur earlier in pregnancy, because that had the potential to cause harm to early fetus. It's pretty clear that just before pregnancy or in early pregnancy, one does not want to be exposed to PVB19. If you had IgG present against PVB19 regular VP capsid protein at the time of exposure, you would probably have been immune to new exposure. If, however, it represented a new infection for you, newer information suggests it is helpful to look more closely at the blood IgM/IgG antibodies, since with persistant/reactivating virus presence in tissue (including heart) shows a pattern of IgG against NonSpecific-1 protein. Was your IgG + against that protein, or just the regular VP capsid protein? When exactly did you have your PVB19 serology tested? (25 wks preg?, 27 weeks preg? after dx PPCM?)

These newer discoveries and reports encourage us these days to go a step further in analysis of the significance of + antibodies against PVB19. Once diagnosed with PPCM or viral myocarditis, the PVB19 status becomes significant if complete healing does not occur. I need to be refreshed about your current LVEF and treatment. I can send you a pdf copy of two related journal articles if you wish, just e-mail me at the address below.
JD

[momof3nc]

Dr Fett

I was 27 weeks when they did the first test which showed positive for exposure. Then at 32 weeks I think I had another test which showed it was a previous exposure. (I had changed OB docs) I did not see the results from it though. I did go last week and have the labs drawn that you had mentioned and got the results in last night. From what I understand of it I am getting over EBV, have been exposed to CMV and am positive for HHV 6. The results are so confusing to read though. Could you decipher them for me if I emailed them to you?

Nichole

[JAMESFETT]

Oh yes, I would love that. Please send them to me and I will try to give the best current interpretation that I possibly can.
I think earlier you had mentioned IgG antibodies against Parvovirus B19. Could you include that information? Thanks.

JD