Severe thrombocytopenia secondary to cytomegalovirus infection in an immunocompetent adult

Ichiche, Malika; Fontaine, Christel; Lacor, Patrick

doi:10.1016/s0953-6205(02)00210-8

Cited by 14 publications

(14 citation statements)

References 15 publications

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“…Previously published case reports confirm that anti-platelet antibodies are rarely detected during the acute phase of CMV infection. 4,6 Thus, it is most likely that in our patient autoimmunity was responsible for CMV-induced pancytopenia, despite the absence of anti-platelet antibodies.…”

Section: Discussionmentioning

confidence: 73%

“…1 Signifi cant involvement of hematopoietic system due to acute CMV infection in immunocompetent patients is scarcely reported in literature. [2][3][4][5][6] We describe a case of fulminant pancytopenia secondary to CMV infection in a previously healthy woman. To our knowledge, no other case of sustained and irreversible leukopenia and thrombocytopenia with subsequent death due to bacterial sepsis in an immunocompetent individual has been reported so far, except for a case of disseminated CMV infection in an apparently normal adult.…”

Section: Introduction and Objectivementioning

confidence: 99%

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Fulminant pancytopenia due to cytomegalovirus infection in an immunocompetent adult

Koukoulaki¹,

Ifanti²,

Grispou³

et al. 2010

Braz J Infect Dis

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We declare no confl ict of interest. ABSTRACTA case of severe and irreversible pancytopenia secondary to acute primary cytomegalovirus infection in an immunocompetent woman is described. The patient presented with thrombocytopenia, lymphopenia, anemia, and abnormal liver function tests. Treatment with corticosteroids and intravenous immunoglobulin was ineffective in reconstituting hemopoiesis. The patient developed severe sepsis and eventually expired.

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Section: Discussionmentioning

confidence: 73%

Section: Introduction and Objectivementioning

confidence: 99%

Fulminant pancytopenia due to cytomegalovirus infection in an immunocompetent adult

Koukoulaki¹,

Ifanti²,

Grispou³

et al. 2010

Braz J Infect Dis

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“…Severe thrombocytopenia due to a CMV infection in immunocompetent patients has been described (25,26). The present patient was treated with steroids, but treatment with ganciclovir was not indicated since CMV antigenemia was not detected.…”

Section: Discussionmentioning

confidence: 99%

Syndrome of Inappropriate Secretion of Antidiuretic Hormone and Thrombocytopenia Caused by Cytomegalovirus Infection In a Young Immunocompetent Woman

et al. 2004

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We report the first case of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with cytomegalovirus (CMV) infection. A 32-yearold woman was admitted to our hospital because of pandysautonomic signs and symptoms. Thrombocytopenia and hyponatremia were present. Serum anti-CMV IgM and IgG antibodies were positive. Despite hyponatremia, urinary osmolality exceeded plasma osmolality and plasma vasopressin levels related to plasma osmolality were high. Restriction of water intake and administration of dimethylchlorotetracycline improved hyponatremia, suggesting this patient had SIADH. In this patient, SIADH may have been caused by acute pandysautonomia that developed following CMV infection.

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“…The search for such complementary antigens is greatly facilitated by the fact that epidemiological studies have identified a narrow range of infectious agents that are highly associated with onset of ITP. These include HIV-1, the herpes viruses, including cytomegalovirus, Streptococcus, Mycobacterium, rubella virus, varicella virus and Helicobacter as some of the most documented infectious agents linked to ITP (Kahane et al 1981, Van Spronsen and Breed 1996, Wright et al 1996, Bar Meir et al 2000, Humblot et al 2001, Candelli et al 2003, Fisgin et al 2003, Ichiche et al 2003, Takahashi et al 2004. Notably, many reports document concurrent infections with two or more of these agents (e.g.…”

Section: Case Study: Idiopathic Thrombocytopenia Purpuramentioning

confidence: 99%

Antigenic Complementarity in the Origins of Autoimmunity: A General Theory Illustrated With a Case Study of Idiopathic Thrombocytopenia Purpura

Root‐Bernstein

Couturier

2006

Journal of Immunology Research

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We describe a novel, testable theory of autoimmunity, outline novel predictions made by the theory, and illustrate its application to unravelling the possible causes of idiopathic thrombocytopenia purpura (ITP). Pairs of stereochemically complementary antigens induce complementary immune responses (antibody or T-cell) that create loss of regulation and civil war within the immune system itself. Antibodies attack antibodies creating circulating immune complexes; T-cells attack T-cells creating perivascular cuffing. This immunological civil war abrogates the self -nonself distinction. If at least one of the complementary antigens mimics a self antigen, then this unregulated immune response will target host tissues as well. Data demonstrating that complementary antigens are found in some animal models of autoimmunity and may be present in various human diseases, especially ITP, are reviewed. Specific mechanisms for preventing autoimmunity or suppressing existing autoimmunity are derived from the theory, and critical tests proposed. Finally, we argue that Koch's postulates are inadequate for establishing disease causation for multiple-antigen diseases and discuss the possibility that current research has failed to elucidate the causes of human autoimmune diseases because we are using the wrong criteria.

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Severe thrombocytopenia secondary to cytomegalovirus infection in an immunocompetent adult

Cited by 14 publications

References 15 publications

Fulminant pancytopenia due to cytomegalovirus infection in an immunocompetent adult

Fulminant pancytopenia due to cytomegalovirus infection in an immunocompetent adult

Syndrome of Inappropriate Secretion of Antidiuretic Hormone and Thrombocytopenia Caused by Cytomegalovirus Infection In a Young Immunocompetent Woman

Antigenic Complementarity in the Origins of Autoimmunity: A General Theory Illustrated With a Case Study of Idiopathic Thrombocytopenia Purpura

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