Cytomegalovirus Mononucleosis with Mixed Cryoglobulinemia Presenting Transient Pseudothrombocytopenia.

Takeuchi, Tohru; Yoshioka, Keiji; Hori, Akihiro; Mukoyama, Kazuyo; Ohsawa, Akira; Yokoh, Sadayoshi

doi:10.2169/internalmedicine.32.598

Cited by 22 publications

(8 citation statements)

References 11 publications

(7 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many HIV þ and HIV ¹ haemophilia patients suffer from chronic viral infections such as hepatitis B, cytomegalovirus (CMV), Epstein-Barr virus (EBV), etc., that are able to induce anti-lymphocyte autoantibodies of the IgM type [29][30][31]. Conceivably, a decrease in IgM-coated CD4 þ lymphocytes reflects the application and efficiency of improved treatment protocols against viral infections during the past years.…”

Section: Discussionmentioning

confidence: 99%

CD4 depletion in HIV-infected haemophilia patients is associated with rapid clearance of immune complex-coated CD4+ lymphocytes

Daniel

Melk

Süsal

et al. 1999

Clinical and Experimental Immunology

View full text Add to dashboard Cite

The predominant immunological finding in HIV+ haemophilia patients is a decrease of CD4+ lymphocytes during progression of the disease. Depletion of CD4+ lymphocytes is paralleled by an increase in the proportion of immune complex-coated CD4+ cells. We examined the hypothesis that the formation of immune complexes on CD4+ lymphocytes is followed by rapid clearance of immune complex-coated CD4+ lymphocytes from the circulation. In this study, the relationship of relative to absolute numbers of immune complex-loaded CD4+ blood lymphocytes and their association with viral load were studied. Two measurements of relative and absolute numbers of gp120-, IgG- and/or IgM-loaded CD4+ lymphocytes were analysed in HIV+ and HIV- haemophilia patients, with a median interval of approx. 3 years. Immune complexes on CD4+ lymphocytes were determined using double-fluorescence flow cytometry and whole blood samples. Viral load was assessed using NASBA and Nuclisens kits. Whereas the proportion of immune complex-coated CD4+ lymphocytes increased with progression of the disease, absolute numbers of immune complex-coated CD4+ lymphocytes in the blood were consistently low. Relative increases of immune complex-coated CD4+ blood lymphocytes were significantly associated with decreases of absolute numbers of circulating CD4+ lymphocytes. The gp120 load on CD4+ blood lymphocytes increased in parallel with the viral load in the blood. These results indicate that immune complex-coated CD4+ lymphocytes are rapidly cleared from the circulation, suggesting that CD4+ reactive autoantibodies and immune complexes are relevant factors in the pathogenesis of AIDS. Relative increases of immune complex-positive cells seem to be a consequence of both an increasing retroviral activity as well as a stronger loading with immune complexes of the reduced number of CD4+ cells remaining during the process of CD4 depletion. The two mechanisms seem to enhance each other and contribute to the progressive CD4 decrease during the course of the disease.

show abstract

Section: Discussionmentioning

confidence: 99%

CD4 depletion in HIV-infected haemophilia patients is associated with rapid clearance of immune complex-coated CD4+ lymphocytes

Daniel

Melk

Süsal

et al. 1999

Clinical and Experimental Immunology

View full text Add to dashboard Cite

show abstract

“…EDTA-PTCP occurs in both healthy subjects and patients with various diseases, with an incidence of approximately 0.1% [3,4]. In only a few cases is transient availability of EDTA-PTCP described [5,6]. In the following description of a patient after gastrectomy we observed an additional case of transiently appearing EDTA-PTCP.…”

Section: Introductionmentioning

confidence: 81%

“…Only in a few case reports regarding EDTA dependent pseudothrombocytopenia, with the underlying illness of acute hepatitis, acute myeloid leukemia, sepsis and cytomegalovirus infection, was the subsequent disappearance of EDTA-dependent platelet clumping after treatment observed [1,5,6,13,14]. Berkman et al [15] demonstrated that the appearance of pseudothrombocytopenia is related to hospitalization and the severity of illness of patients, suggesting that EDTA dependent pseudothrombocytopenia might be an acquired phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Transient appearance of postoperative EDTA-dependent pseudothrombocytopenia in a patient after gastrectomy

et al. 2010

View full text Add to dashboard Cite

Ethylenediaminetetraacetic acid-dependent pseudothrombocytopenia (EDTA-PTCP) is a well known phenomenon. Antiplatelet antibodies cause platelet clumping in EDTA anticoagulated blood samples, and blood count analysers calculate a spurious low platelet count. We describe a case of a transient appearance of EDTA-PTCP in a patient after gastrectomy. A 58-year-old man underwent partial gastrectomy in for gastric cancer. Preoperatively, his platelet count was in a normal range, and the surgical procedure was performed without bleeding complications. At day 10 after surgery the patient showed a low platelet count, which could be identified as EDTA-PTCP. The phenomenon disappeared in a following postoperative time interval of 2 months. In cases of recently occurring thrombocytopenias EDTA-PTCP should always be considered as a possible cause of low platelet count, in particular in cases of inconspicuous clinical findings. Appropriate laboratory analysis should be applied.

show abstract

“…Several complications or associated manifestations have been described in immunocompetent patients with CMV infection, including severe pneumonia, granulomatous hepatitis [7], Guillain–Barré syndrome [8], meningoencephalitis [9], myocarditis [10], thrombocytopenic purpura [11], erythema nodosum [12], crioglobulinaemia [13], vasculitis [14], vascular thrombosis [15] and colitis [16]. Protracted CMV infections with malaise, fever and persistent lymphocytosis have been described in infants [17], but we are not aware of reported cases of CMV mononucleosis as a cause of protracted fever with prominent weight loss in immunocompetent adults.…”

Section: Laboratory Data On Admission For Patients In Groupmentioning

confidence: 99%

Cytomegalovirus mononucleosis as a cause of prolonged fever and prominent weight loss in immunocompetent adults

Muniain¹,

Borobio

Corral

et al. 2004

Clinical Microbiology and Infection

View full text Add to dashboard Cite

Four immunocompetent adults presented with protracted fever lasting > 6 weeks and severe weight loss, associated with primary cytomegalovirus (CMV) infection. Each patient had spleen enlargement, lymphocytosis and hypertriglyceridaemia, but recovered spontaneously. A further 20 immunocompetent patients with primary CMV infection were also reviewed, and all presented the usual clinical picture of CMV mononucleosis. It was concluded that CMV mononucleosis should be considered in the differential diagnosis in patients with prolonged fever and weight loss if lymphocytosis is present.

show abstract

Cytomegalovirus Mononucleosis with Mixed Cryoglobulinemia Presenting Transient Pseudothrombocytopenia.

Cited by 22 publications

References 11 publications

CD4 depletion in HIV-infected haemophilia patients is associated with rapid clearance of immune complex-coated CD4+ lymphocytes

CD4 depletion in HIV-infected haemophilia patients is associated with rapid clearance of immune complex-coated CD4+ lymphocytes

Transient appearance of postoperative EDTA-dependent pseudothrombocytopenia in a patient after gastrectomy

Cytomegalovirus mononucleosis as a cause of prolonged fever and prominent weight loss in immunocompetent adults

Contact Info

Product

Resources

About