Hypogammaglobulinemia associated with cytomegalovirus pneumonia.
Transient but profound hypogammaglobulinemia occurred during cytomegalovirus (CMV) pneumonia in a patient who developed striking declines in number of T lymphocytes. A 66-year-old, female, human immunodeficiency virus-negative patient requiring long-term hemodialysis had normal serum immunoglobulin concentrations before the onset of CMV pneumonia (IgG, 1070-1470 mg/dl; IgA, 94-102 mg/dl; IgM, 30-48 mg/dl). During the pneumonia episode, serum immunoglobulin concentrations were profoundly reduced (IgG, 440 mg/dl; IgA, 40 mg/dl; IgM, 25 mg/dl). Total lymphocytes declined from 3048/mm3 to 212/mm3 with reductions in CD4+CD45- lymphocytes (inducers of B cells) to 9% (nl, 24%-32%) and CD4+CD45+ lymphocytes (inducers of suppressor T cells) to 4% (nl, 14%-22%). CD8 lymphocytes were reduced to 5% (nl, 19%-31%). As the pneumonia resolved, serum immunoglobulin concentrations returned to normal. This is one of the few reported instances of CMV infection apparently causing hypogammaglobulinemia.
Greenberger
P A
PA
Section of Allergy-Immunology, Northwestern University Medical School, Chicago, IL 60611.
Walker
C L
CL
Fitzsimons
T E
TE
Roberts
M
M
D000361:Agammaglobulinemia / Q000209:etiology* / Q000276:immunology; D000368:Aged; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000276:immunology; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis*; D007958:Leukocyte Count; D016131:Lymphocyte Subsets; D008214:Lymphocytes; D011024:Pneumonia, Viral / Q000150:complications* / Q000276:immunology
D007136:Immunoglobulins