Cytomegalovirus infection mimicking juvenile myelomonocytic leukemia showing hypersensitivity to granulocyte-macrophage colony stimulating factor.
We describe an infant with cytomegalovirus (CMV) infection presenting as transient myeloproliferation resembling juvenile myelomonocytic leukemia (JMML). The patient fulfilled the international diagnostic criteria of JMML, including hypersensitivity to granulocyte-macrophage colony-stimulating factor (GM-CSF). Viral studies using serologic assays and polymerase chain reaction (PCR) were positive for CMV. Clinical symptoms disappeared and laboratory values returned to normal without specific treatment within 1 year. Follow-up showing a decrease in viral titers suggested CMV infection as an etiologic factor for the development of myeloproliferative features. We conclude that the CMV infection transiently induced abnormal myelopoiesis in this infant.
Moritake
Hiroshi
H
Division of Pediatrics, Faculty of Medicine, Department of Reproductive and Developmental Medicine, University of Miyazaki, Miyazaki, Japan. moritake@fc.miyazaki-u.ac.jp
Ikeda
Toshio
T
Manabe
Atsushi
A
Kamimura
Sachiyo
S
Nunoi
Hiroyuki
H
D000914:Antibodies, Viral / Q000097:blood; D001853:Bone Marrow / Q000473:pathology; D002455:Cell Division / Q000187:drug effects; D002478:Cells, Cultured / Q000187:drug effects; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005183:Failure to Thrive / Q000209:etiology; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D006529:Hepatomegaly / Q000209:etiology; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007223:Infant; D054429:Leukemia, Myelomonocytic, Juvenile / Q000175:diagnosis*; D038042:Myelopoiesis / Q000187:drug effects; D010766:Phosphorylation / Q000187:drug effects; D011499:Protein Processing, Post-Translational / Q000187:drug effects; D050799:STAT5 Transcription Factor / Q000378:metabolism; D013163:Splenomegaly / Q000209:etiology
D000914:Antibodies, Viral; D007075:Immunoglobulin M; D050799:STAT5 Transcription Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor