Fifth Disease Sequelae

I am a healthy 35y/o female with virtually no medical history, normal weight, run 8 miles a week plus lift weights, follow a mediterranean diet, no smoking, only social drinking.  I was diagnosed with Fifth Disease in April after a series of events, both of my children had Fifth disease before and during this time.  I had developed polyarthropy in all extremities fairly severe, fatigue, no rash.  My ANA levels were greater than 6, RF normal, ESR slightly high, & TSH normal, positive for Parvovirus as well.  After seeing a rheumatologist, he concluded that I had Fifth's Disease, did 4 weeks of blood work and then released me from his care.  My symptoms subsided quite a bit, but not gone.  He said it could last up to 6 months and some cases up to several years.    

Over the summer months, I began to feel the "arthritic" pain occassionally again.  In August, I was stung by a hornet and had an allergic reaction, the first in my life to anything.  4 1/2 weeks ago, I developed what I thought to be cold sores in the corners in my mouth, severely chapped lips.  After 4 weeks, my dentist felt it was a fungal infection, asked if I was B-12 defiicent, prescribed Nystatin, which cleared it up in 3 days.  My mentrual periods went from being quite heavy 6-7 days long  to now a total of a day and a half and quite light.  I have been feeling the joint pain more over the last week as well and am having a painful tingling sensation in the heels of my feet.

My question is, what is going on in my body?  It appears to be acting like an autoimmune disease.  I also don't know what to do.  Is this Fifth Disease?  Has it triggered something else?  Is it unrelated?  I am scheduled to see my PCP on the 20th of the month, is that too long to wait?  

[Kevin Pho, MD]

I agree that the symptoms from fifth disease can vary from patient to patient.  Before attributing it to this, you may want to inquire and exclude other diseases.  If the parvovirus is truly the cause of the symptoms, discussion of whether IVIG is suitable should be considered with your physician.

Repeating the ANA and rheumatoid faction can be done.  If the ANA continues to be positive, further investigation of other antibodies can be made to exclude other rheumatological disease like lupus or rheumatoid arthritis.

Would re-consult a rheumatology referral, an obtain another opinion preferably at a major academic medical center.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com