A case of severe and irreversible pancytopenia secondary to acute primary cytomegalovirus infection in an immunocompetent woman is described. The patient presented with thrombocytopenia, lymphopenia, anemia, and abnormal liver function tests. Treatment with corticosteroids and intravenous immunoglobulin was ineffective in reconstituting hemopoiesis. The patient developed severe sepsis and eventually expired.
Journal Information
Vol. 14. Issue 2.
Pages 180-182 (March - April 2010)
Vol. 14. Issue 2.
Pages 180-182 (March - April 2010)
Case report
Open Access
Fulminant pancytopenia due to cytomegalovirus infection in an immunocompetent adult
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Maria Koukoulaki1,
, Georgia Ifanti2, Eirini Grispou3, Vassilios Papastamopoulos1, Georgia Chroni2, Emmanouil Diamantopoulos2, Athanasios Skoutelis1
Corresponding author
mkoukoulaki@gmail.com
Correspondence to: 5th Department of Medicine, “Evangelismos” General Hospital 45-47 Ipsilantou street, 106 76 – Athens – Greece. Phone: 30 210 7201830 Fax: 30 210 7216408.
Correspondence to: 5th Department of Medicine, “Evangelismos” General Hospital 45-47 Ipsilantou street, 106 76 – Athens – Greece. Phone: 30 210 7201830 Fax: 30 210 7216408.
1 15th Department of Medicine, Division of Infectious Diseases, “Evangelismos” General Hospital, 45 - 47 Ipsilantou street, 106 76 Athens, Greece
2 4th Department of Medicine, “Evangelismos” General Hospital, 45 - 47 Ipsilantou street, 106 76 Athens, Greece
3 Department of Microbiology, “Evangelismos” General Hospital, 45 - 47 Ipsilantou street, 106 76 Athens, Greece
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Article information
Abstract
Keywords:
cytomegalovirus
pancytopenia
immunocompetent
fulminant
irreversible
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References
[1.]
J.G. Sissons, A.J. Carmichael.
Clinical aspects and management of cytomegalovirus infection.
J Infect, 44 (2002), pp. 78-83
[2.]
V.K. Rustgi, R.A. Sacher, P. OBrien, V.F. Garagusi.
Fatal disseminated cytomegalovirus infection in an apparently normal adult.
Arch Intern Med., 143 (1983), pp. 372-373
[3.]
J.G. Wright.
Severe thrombocytopenia secondary to asymptomatic cytomegalovirus infection in an immunocompetent host.
J Clin Pathol., 45 (1992), pp. 1037-1038
[4.]
D.J. van Spronsen, W.P. Breed.
Cytomegalovirus-induced thrombocytopenia and haemolysis in an immunocompetent adult.
Br J Haematol., 92 (1996), pp. 218-220
[5.]
G. Gavazzi, P. Leclercq, O. Bouchard, A. Bosseray, P. Morand, M. Micoud.
Association between primary cytomegalovirus infection and severe hemolytic anemia in an immunocompetent adult.
Eur J Clin Microbiol Infect Dis., 18 (1999), pp. 299-301
[6.]
M. Ichiche, C. Fontaine, P. Lacor.
Severe thrombocytopenia secondary to cytomegalovirus infection in an immunocompetent adult.
Eur J Intern Med., 14 (2003), pp. 56-59
[7.]
M.K. Gandhi, R. Khanna.
Human cytomegalovirus: clinical aspects, immune regulation, and emerging treatments.
Lancet Infect Dis., 4 (2004), pp. 725-738
[8.]
C. Steininger, M. Kundi, J. Kletzmayr, S.W. Aberle, T. Popow-Kraupp.
Antibody maturation and viremia after primary cytomegalovirus infection, in immunocompetent patients and kidney-transplant patients.
The Journal of infectious diseases, 190 (2004), pp. 1908-1912
[9.]
V.C. Emery, C.A. Sabin, A.V. Cope, D. Gor, A.F. Hassan-Walker, P.D. Griffiths.
Application of viral-load kinetics to identify patients who develop cytomegalovirus disease after transplantation.
Lancet, 355 (2000), pp. 2032-2036
[10.]
Cytomegalovirus. Am J Transplant. 2004 Nov; 4 Suppl 10:51-8.
[11.]
J.P. Maciejewski, E.E. Bruening, R.E. Donahue, E.S. Mocarski, N.S. Young, S.C. St Jeor.
Infection of hematopoietic progenitor cells by human cytomegalovirus.
Blood, 80 (1992), pp. 170-178
[12.]
P. Simmons, K. Kaushansky, B. Torok-Storb.
Mechanisms of cytomegalovirus-mediated myelosuppression: perturbation of stromal cell function versus direct infection of myeloid cells.
Proc Natl Acad Sci U S A, 87 (1990), pp. 1386-1390
[13.]
S. Ina, M. Tani, K. Takifuji, S. Yamazoe, Y. Nakatani, H. Yamaue.
Virus-associated hemophagocytic syndrome and hemorrhagic jejunal ulcer caused by cytomegalovirus infection in a noncompromised host; a case report of unusual entity.
Hepatogastroenterology, 51 (2004), pp. 491-493
[14.]
V. Panoutsakopoulou, M.E. Sanchirico, K.M. Huster, et al.
Analysis of the relationship between viral infection and autoimmune disease.
Immunity, 15 (2001), pp. 137-147
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