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To relate the clinical findings of parvovirus B19 infection to the phase of the disease, we performed a retrospective chart review of 30 adult patients who tested positive for IgM antibody against parvovirus B19 at our hospital from March 2003 to November 2008. Median patient age was 38 years, with 86.7% aged between 26 and 45 years. The male-to-female ratio was 4:26 (86.7% female). Symptoms in the first phase were mainly flu-like, including fever, headache, or myalgia. Symptoms in the second phase were arthralgia in 24 (85.7%) and rash in 23 (82.1%). Fever was observed in 21 (70.0%), and 22 (75.9%) were found to be lymphopenic. The onsets in 73.3% of cases were concentrated within 10.1% of the study period, an observation nearly consistent with an outbreak of erythema infectiosum. Three patients had symmetrical swelling of joints, all of whom also had rash. Most patients visited the hospital within a week of onset and prognosis was favorable. In the parvovirus B19 infection, flu-like symptoms were frequent in the first phase, while rash and arthralgia were common in the second. Female sex, age between 26 and 45, and presence of rash, arthralgia, fever, and lymphopenia were clinical findings with a high frequency (≥70%), and these factors may contribute to diagnosis. In an era when early diagnosis and therapy is required in rheumatoid arthritis, it is important to recognize the parvovirus B19 infection with a presentation of acute arthritis and a favorable prognosis.

A 50-year-old man was admitted to hospital for dysphagia. The upper gastrointestinal series revealed esophageal stricture, pyloric stenosis, and hypomotile small intestine. He was diagnosed with systemic sclerosis sine scleroderma with gastrointestinal involvement. After subtotal gastrectomy with Billroth 2 anastomosis, he had recurrent intestinal pseudo-obstruction and perforation of the afferent loop. Our experience indicates that surgical procedures in bowel scleroderma, in which an afferent loop is reconstructed, could easily cause perforation of the afferent loop.

A 54-year-old man was admitted to hospital with fever, dyspnea, and polyarthralgia. A chest radiograph showed consolidations in the bilateral lungs, and histological examination of transbronchial lung biopsy samples revealed organizing pneumonia. He was also diagnosed with polymyositis because of muscle weakness, elevated muscle enzymes, myogenic findings on the electromyogram, and a positive test for the anti-Jo-1 antibody. Herein, we review 25 cases of organizing pneumonia with polymyositis/dermatomyositis with respect to their clinical features and treatment.