T-gamma gene rearrangement and CMV mononucleosis.
A clonal T-gamma rearrangement was found in peripheral blood and bone marrow in a 57-year-old female who presented with 6-week history of fevers, night sweats, and weight loss. Splenomegaly, hemolytic anemia, atypical lymphocytosis, a marrow lymphoid aggregate, and elevated LDH had suggested lymphoproliferative disease. However, IgM serology for cytomegalovirus (CMV) was positive. With observation alone, her clinical features improved over 4 weeks with normalization of the blood count and disappearance of CMV viremia and the aberrant T-gamma clone. Acute CMV infection may mimic lymphoproliferative disease. T-gamma gene rearrangement may be part of the immune response to CMV infection and is not specific to lymphoid neoplasia.
Mathew
P
P
Department of Internal Medicine, University of Texas Medical Branch, Galveston 77555-0565, USA. pamathew@utmb.edu
Hudnall
S D
SD
Elghetany
M T
MT
Payne
D A
DA
D000914:Antibodies, Viral / Q000097:blood; D001773:Blood Cells / Q000737:chemistry; D001854:Bone Marrow Cells / Q000737:chemistry; D002999:Clone Cells / Q000737:chemistry; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000276:immunology*; D003937:Diagnosis, Differential; D005260:Female; D015334:Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D016130:Immunophenotyping; D007244:Infectious Mononucleosis / Q000175:diagnosis / Q000276:immunology*; D008232:Lymphoproliferative Disorders / Q000175:diagnosis; D008875:Middle Aged; D016176:T-Lymphocyte Subsets / Q000737:chemistry*; D014766:Viremia / Q000276:immunology
D000914:Antibodies, Viral; D007075:Immunoglobulin M