Thrombosis associated with acute cytomegalovirus infection: A meta-analysis

Cytomegalovirus-Associated Splanchnic Vein Thrombosis in Immunocompetent Patients: Two Case Reports and Literature Review

“…Other predisposing conditions were surgery, active malignancy, and pregnancy. 6 Interestingly, the prevalence of inherited thrombophilia was significantly higher among immunocompetent patients compared with immunocompromised patients, 6 thus suggesting a prothrombotic state associated with the condition of immunosuppression of these patients to be sufficient to induce the thrombosis.…”

“…13 Clinical characteristics of patients with CMV-associated thrombosis were also evaluated in a meta-analysis, published in 2011, that included 97 reports. 6 Overall, 64 immunocompetent patients and 33 immunocompromised patients were described, with a mean age of 39.7 AE 14.9 years and a femaleto-male ratio of 1:1, although females were prevalent among the immunocompetent cases. The most prevalent clinical presentations of infection were CMV mononucleosis and CMV colitis.…”

“…Arterial thromboses (renal infarct, myocardial infarction, digital ischemia) were rare. 6 In the meta-analysis, the use of OCs, transient/permanent antiphospholipid antibody (APLA) positivity, and FVL heterozygosis were the most common concomitant predisposing conditions for thrombosis. Other predisposing conditions were surgery, active malignancy, and pregnancy.…”

“…4,15,18,19 However, unlike immunosuppressed patients, in whom infection is often the only condition associated with thrombosis, inherited thrombophilia and acquired risk factors for thrombosis often coexist in immunocompetent patients with SVT. 6,18 In a review of case reports and case series on CMVassociated thrombosis in immunocompetent adults, 18 39 patients were described (mean age: 34.9 AE 10.8 years). Most events (21/39; 54%) were SVT.…”

“…20 Therapy was stopped when the resolution of thrombosis was confirmed or, in some cases, on the basis of reduction or absence of APLA. 6,20 Three months of anticoagulant therapy seems to be the most appropriate strategy since CMV infection is a transient and reversible risk factor, according to the current guidelines of the American College of Chest Physicians. 25,26 However, the search for inherited thrombophilia and APLA should guide the choice of extended treatment.…”