title: [Clinical analysis of 50 cases of cytomegalovirus disease].
abstract: OBJECTIVE
  To investigate the clinical features, diagnostic methods, therapeutic approaches, outcomes and the alterations of peripheral lymphocyte subsets in cytomegalovirus (CMV) diseases.
  
  
  METHODS
  From August 2000 to October 2002, 50 cases of CMV diseases were treated in Peking Union Medical College Hospital. The diagnosis were made by their symptoms and positive CMV pp65 antigen or/and CMV specific IgM. Of the 50 patients, 15 were male, and 35 female. Their age was (35.5 +/- 16.2) years. Their clinical data were collected, and their peripheral lymphocyte subsets were measured at the time when they were first diagnosed as CMV disease. The lymphocyte subsets of 51 healthy blood donors were tested as normal controls. The lymphocyte subsets were compared between those who had an immunocompromising underlying disease and those who had not.
  
  
  RESULTS
  (1) CMV disease occurred in 39 patients who had immunocompromising underlying diseases, and in 11 patients who had not; (2) CMV disease caused various symptoms, most of them were nonspecific. Fever (100%), hematological abnormalities (96%) and abnormal liver function test (30%) were the most common manifestations. 3 cases of CMV retinitis were acquired immune deficiency syndrome patients with CD4+ T cell count less than 50/ microl; 2 patients developed multiple organ failure; (3) The positive rates of CMV pp65 antigen and specific IgM assays were 85.3% and 68.3%, respectively; (4) Comparing with normal controls, all patients with CMV disease had decreased B cell and nature killer cells, increased CD8+ T cell percentage and a reversed CD4+/CD8+ ratio; further more, the patients with underlying diseases had lower CD4+ T-cell and CD8+ T-cell counts than those without underlying diseases.
  
  
  CONCLUSIONS
  CMV disease occurred in patients with or without underlying diseases. Their clinical manifestations were heterogeneous and non-specific, therefore, special laboratory tests were necessary to confirm the diagnosis. pp65 antigen assay had more diagnostic value than IgM assay. The dramatic changes in lymphocyte subsets suggest CMV disease has a immunological pathogenesis.
authors.affiliation: Department of Infectious diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Huan-ling
authors.initials: HL
authors.lastname: Wang
authors.forename: Zhi-feng
authors.initials: ZF
authors.lastname: Qiu
authors.forename: Rui-yuan
authors.initials: RY
authors.lastname: Sheng
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhao
authors.forename: Xiao-chun
authors.initials: XC
authors.lastname: Zhu
authors.forename: Ying-ying
authors.initials: YY
authors.lastname: Hao
authors.forename: Hong-wei
authors.initials: HW
authors.lastname: Fan
authors.forename: Wei
authors.initials: W
authors.lastname: Lu
authors.forename: Xiao-jun
authors.initials: XJ
authors.lastname: Ma
authors.forename: Zheng-yin
authors.initials: ZY
authors.lastname: Liu
authors.forename: Tai-sheng
authors.initials: TS
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000956:Antigens, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000276:immunology; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007223:Infant; D016131:Lymphocyte Subsets / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010750:Phosphoproteins / Q000097:blood; D014763:Viral Matrix Proteins / Q000097:blood
chemical_list: D000956:Antigens, Viral; D007075:Immunoglobulin M; D010750:Phosphoproteins; D014763:Viral Matrix Proteins; C065418:cytomegalovirus matrix protein 65kDa