An infant with refractory cytomegalovirus‐induced thrombocytopenia

Uemura, Suguru; Mori, Takeshi; Nino, Nanako; Sakakibara, Noburu; Takafuji, Satoru; Myojin, Shota; Takami, Yuichi; Morioka, Ichiro; Nishimura, Noriyuki; Kugo, Masaaki; Iijima, Kazumoto

doi:10.1002/ccr3.2581

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…Rash and hepatomegaly are present in 33% and 10%-38% of patients, respectively [ 14 ]. Atypical leukocytes are almost always seen [ 7 ]. Hematologic abnormalities, such as thrombocytopenia, pancytopenia, disseminated intravascular coagulation, and myelodysplastic changes, can also be present.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, no clear guidelines are available for the treatment of CMV hepatitis in immunocompetent hosts, and treatment with antiviral agents is still controversial [1,4,11,15]. For immunocompetent individuals, treatment is usually not required [1,2,[6][7][8][9]11,13,14,17]. The severity and potential morbidity of CMV disease must be balanced against the potential side effects of the treatment, including myelosuppression (neutropenia), central nervous system disorders, hepatotoxicity, irreversible infertility (inhibition of spermatogenesis), or teratogenesis [6].…”

Section: Discussionmentioning

confidence: 99%

“…Previously healthy children with an acquired CMV infection are usually asymptomatic. In 10% of the cases, it may present as a mononucleosis-like syndrome [6], characterized by the presence of fever, fatigue, pharyngitis, adenopathy, and hepatitis, which is usually benign and self-limited [5][6][7][8]. More severe presentations, including fulminant hepatic failure [1,9], pneumonitis, encephalitis, thrombocytopenia, vasculitis, colitis, and retinitis, are well described in cases of immunocompromised children, congenital or perinatal CMV infections, or acquired infections in premature infants.…”

Section: Introductionmentioning

confidence: 99%

“…However, these complications are thought to be rare in immunocompetent children. Misdiagnosis and a lack of reporting may also play a role in this apparently low prevalence [1,2,3,[5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Multisystemic Disease in a Child and Successful Recovery With Antiviral Treatment

Rodrigues,

Correia de Azevedo,

Nobre

et al. 2024

Cureus

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Cytomegalovirus (CMV), a member of the Herpesviridae family, typically causes asymptomatic infections or mild mononucleosis-like syndromes in immunocompetent individuals. However, severe manifestations are well-documented in immunocompromised populations. This case report presents a previously healthy seven-year-old girl with a rare and complex presentation of primary CMV infection leading to severe multiorgan involvement, hepatosplenomegaly, cholestasis, bicytopenia, and a prolonged disease course. The patient's condition prompted an exhaustive diagnostic investigation, ruling out other potential causes. The diagnosis was confirmed by positive CMV IgM and IgG antibodies and a significantly elevated CMV DNA viral load. Treatment with intravenous ganciclovir resulted in a remarkable recovery. The case underscores the importance of considering CMV as a potential etiology of hepatitis, even in immunocompetent children, and the challenges of diagnosing complicated CMV infections. While guidelines for treating CMV in immunocompetent individuals are lacking, this report suggests that antiviral therapy may be beneficial in severe cases. Further research is needed to establish clear treatment protocols for such instances. This report contributes to the limited body of literature on severe CMV-induced hepatitis in immunocompetent children, emphasizing the need for heightened clinical awareness and timely interventions to prevent progression to acute liver failure.

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Section: Discussionmentioning

confidence: 99%