Phantom cytomegalovirus infection in vasculitis patients: what it means and what to do.
We report our experience and hypothesis on the diagnosis and treatment of patients with vasculitis who are simultaneously diagnosed with serum-positive cytomegalovirus (CMV) immunoglobulin (Ig)M antibodies and negative CMV DNA polymerase chain reaction (PCR). It remains unknown how to treat this kind of "phantom" CMV infection. In a patient diagnosed with Henoch-Schönlein vasculitis, CMV IgM titers were increased while angiitis and renal function deteriorated. Empiric treatment of phantom CMV infection with ganciclovir in this CMV IgM-positive and PCR-negative patient resulted in complete vasculitis remission, serum CMV antibody seroconversion, and renal function improvement. These results imply something more than coincidence.
Katsanos
Konstantinos H
KH
Department of Internal Medicine, Medical School, University of Ioannina, Greece.
Kostoula
Aggeliki
A
Katopodis
Konstantinos P
KP
Siamopoulos
Kostas C
KC
D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000276:immunology* / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D004279:DNA, Viral / Q000097:blood*; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007075:Immunoglobulin M; D016133:Polymerase Chain Reaction; D016896:Treatment Outcome; D014657:Vasculitis / Q000150:complications* / Q000188:drug therapy
D000914:Antibodies, Viral; D000998:Antiviral Agents; D004279:DNA, Viral; D007075:Immunoglobulin M; D015774:Ganciclovir