Multi-organ affecting CMV-associated cryoglobulinemic vasculitis

Kramer, Jan; Hennig, H; Lensing, C; Krüger, S; Helmchen, U.; Steinhoff, Jürgen; Dodt, Christoph

doi:10.5414/cnp66284

Cited by 13 publications

(2 citation statements)

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“…The association between CMV and MGUS (table 1) has been demonstrated previously in cohort studies with immunodeficient patients 9–17. Reports on this phenomenon in immunocompetent individuals are scarce and limited to three case reports and one small cohort study 18–21. In this cohort study, 10 out of 25 (40%) immunocompetent patients with acute CMV infection developed concurrent MGUS, compared with none in a control group consisting of patients with acute EBV infection 21.…”

Section: Discussionsupporting

confidence: 61%

Cytomegalovirus infection with pulmonary embolism, splenic vein thrombosis and monoclonal gammopathy of undetermined significance: a case and systematic review

et al. 2019

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A 62-year-old immunocompetent woman was admitted with cytomegalovirus (CMV) infection, pulmonary embolism, splenic vein thrombosis and monoclonal gammopathy of undetermined significance (MGUS). Anticoagulation therapy was started. Two months later, seroconversion of CMV IgM to IgG was observed, while the monoclonal protein was no longer detectable. This suggests a relationship between acute CMV infection, transient MGUS and thrombosis. In accordance with current best practice guidelines for provoked venous thromboembolism (VTE), anticoagulation therapy could be discontinued after 3 months instead of 6 for unprovoked VTE, thereby reducing unnecessary time at risk of bleeding complications. While the relationships between CMV and both MGUS and thrombosis have been described independently, we are first to describe these three conditions occurring simultaneously.Furthermore, we provide a systematic review on the relation between CMV, MGUS and thrombosis.

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Section: Discussionsupporting

confidence: 61%

Cytomegalovirus infection with pulmonary embolism, splenic vein thrombosis and monoclonal gammopathy of undetermined significance: a case and systematic review

et al. 2019

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“…123 DAH was noted in multiorgan-affecting, cytomegalovirus-associated cryoglobulinemic vasculitis. 124 MANAGEMENT OF DIFFUSE ALVEOLAR HEMORRHAGE DAH in primary vasculitis may develop slowly and progressively, either isolated or as part of systemic vasculitis. However, it may be severe right away or worsen rapidly or progressively.…”

Section: Diffuse Alveolar Hemorrhage In Connective Tissue Diseasementioning

confidence: 99%

Alveolar Hemorrhage in Vasculitis: Primary and Secondary

Cordier

Cottin

2011

Semin Respir Crit Care Med

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Diffuse alveolar hemorrhage (DAH) in primary and secondary vasculitis occurs when capillaritis is present. The diagnosis of DAH is considered in patients who develop progressive dyspnea with alveolar opacities on chest imaging (with density ranging from ground glass to consolidation) that cannot be explained otherwise. Hemoptysis, a valuable sign, is often absent. A decline of blood hemoglobin level over a few days without hemolysis or any hemorrhage elsewhere should be an alert for DAH. Bronchoalveolar lavage, retrieving bright red fluid, is the best diagnostic clue. Lung biopsy is not recommended. A search for anti-neutrophil cytoplasmic autoantibodies (ANCAs) is mandatory. Once DAH is diagnosed and hemodynamic as well as infectious causes have been excluded, ANCA-associated vasculitis is taken into account (mainly microscopic polyangiitis or Wegener granulomatosis, and, exceptionally, Churg-Strauss syndrome). Drug-induced DAH, especially antithyroid drugs such as propylthiouracil may be coupled with ANCA. Isolated DAH with capillaritis with or without ANCA is rare. DAH in systemic lupus erythematosus is either associated or not with capillaritis. Treatment of DAH should target the underlying disorder. In the primary vasculitides, corticosteroids and immunosuppressants, especially cyclophosphamide, are the mainstay of therapy, but plasma exchange, particularly in severe DAH, is the rule, although evidence of its effectiveness is awaited.

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Cryoglobulins and Cryoglobulinemia

Gonsalves

Gertz

2016

Nonmalignant Hematology

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Multi-organ affecting CMV-associated cryoglobulinemic vasculitis

Cited by 13 publications

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Cytomegalovirus infection with pulmonary embolism, splenic vein thrombosis and monoclonal gammopathy of undetermined significance: a case and systematic review

Cytomegalovirus infection with pulmonary embolism, splenic vein thrombosis and monoclonal gammopathy of undetermined significance: a case and systematic review

Alveolar Hemorrhage in Vasculitis: Primary and Secondary

Cryoglobulins and Cryoglobulinemia

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