Cytomegalovirus Pneumonitis in a Patient with Homozygous β-Thalassemia and Splenectomy

Fragkiadakis, Konstantinos; Ιωάννου, Πέτρος; Papadakis, John A.; Hatzidakis, Adam; Gikas, Achilleas; Kofteridis, Diamantis P.

doi:10.7883/yoken.jjid.2018.039

Cited by 3 publications

(2 citation statements)

References 10 publications

(11 reference statements)

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“…Totally, 20 studies reporting on 30 different patients were considered eligible for inclusion. [7–26]…”

Section: Resultsmentioning

confidence: 99%

The immunity features and defects against primary cytomegalovirus infection post-splenectomy indicate an immunocompromised status

Liatsos

2019

Medicine

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Background:To evaluate if splenectomy results in severely impaired immune responses against primary cytomegalovirus (CMV) infection compared to the general immunocompetent population.Methods:We performed a systemic literature review to study CMV infections in splenectomized individuals, a special population group presently considered immunocompetent to viral infections. We retrieved 30 cases with established CMV infection post-splenectomy and we recorded their disease manifestations, laboratory findings, immunological studies, and histopathology reports. In addition, we retrieved numerous multidisciplinary articles in view of post-splenectomy immunology defects, as well as of immune responses to primary invading CMV in the absence of the spleen. Two clinical studies directly comparing splenectomized with nonsplenectomized individuals under severe iatrogenic immunosuppression as well as the numerically largest review articles of CMV infections in immunocompetent were retained.Results:Splenectomy results in the loss of spleen's ability to fend-off blood-borne pathogens and impairs the link between innate and adaptive immunity. The major post-splenectomy immune-defects against CMV are: weakened, delayed or absent anti-CMV IgM, and compensatory marked IgG response; severely impaired B-cell and CD4+, CD8+ T-cells function responses; and post-splenectomy, bone marrow compensates for the absence of spleen's immune responses against CMV, mimicking a monoclonal T-cell lymphoproliferative process.Conclusion:The puzzled diagnosis of the CMV syndrome post-splenectomy is of the most challenging and misleading, resulting in risky and costly interventions and a subsequent prolonged hospitalization (2 months). The mounting multi-disciplinary literature evidence renders us to suggest that splenectomized individuals are not only prone to encapsulated bacteria but also behave as immunocompromised to CMV.

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“…Totally, 20 studies reporting on 30 different patients were considered eligible for inclusion. [7–26]…”

Section: Resultsmentioning

confidence: 99%

The immunity features and defects against primary cytomegalovirus infection post-splenectomy indicate an immunocompromised status

Liatsos

2019

Medicine

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“…Splenectomy plays a pivotal role in managing anemia; however, it is associated with its own set of complications including increased risk of infections, hypercoagulability, and thromboembolism [3]. Owing to this reason, splenectomy, a very impactful surgical procedure, can be considered a key part of treatment and thus decreases blood exhaustion [6,7]. Apart from anatomical and physiological changes associated with thalassemia, there is an increased rate of various psychological problems such as depression and anxiety [2].…”

Section: Introductionmentioning

confidence: 99%

Concomitant Pre- and Post-splenectomy Physiotherapy Rehabilitation in a 17-Year-Old Patient With Beta Thalassemia Major: A Case Report

Choubisa¹,

Jain²,

Vardhan³

et al. 2022

Cureus

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Thalassemia is a group of disorders having hematological origin. It is hereditary in nature, characterized by a defect in the synthesis of alpha or beta chains of hemoglobin leading to alpha or beta thalassemia, respectively. Based on the severity, beta thalassemia can be minor, intermittent, or major. Patients with thalassemia major require frequent blood transfusions, which come with various complications, of which hepatosplenomegaly is the most common. A 17-year-old male patient had a chief complaint of stomach ache and fever for the last five days. He was on a monthly blood transfusion. USG impression revealed hepatosplenomegaly and cholelithiasis. Splenectomy along with cholecystectomy was done as a part of surgical management after which a comprehensive pre-and postoperative physiotherapeutic rehabilitation program has been inculcated incorporating various respiratory techniques, strength training, and home exercise program, hence helping the patient to return to his routine daily activities efficiently. The Numeric Pain Rating Scale, Fatigue Severity Scale, and Beck Anxiety Inventory were used as outcome measures over four weeks to demonstrate the efficacy of the treatment. In this case study, a well-planned comprehensive physiotherapy rehabilitation protocol has proven helpful in improving quality of life, maximizing functional capacity, and reducing anxiety and depression in the patient.

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Pulmonary cytomegalovirus infection: A case report and systematic review

Kanika,

Soldera

2023

World J Meta-Anal

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Cytomegalovirus Pneumonitis in a Patient with Homozygous β-Thalassemia and Splenectomy

Cited by 3 publications

References 10 publications

The immunity features and defects against primary cytomegalovirus infection post-splenectomy indicate an immunocompromised status

The immunity features and defects against primary cytomegalovirus infection post-splenectomy indicate an immunocompromised status

Concomitant Pre- and Post-splenectomy Physiotherapy Rehabilitation in a 17-Year-Old Patient With Beta Thalassemia Major: A Case Report

Pulmonary cytomegalovirus infection: A case report and systematic review

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