title: [Cytomegalovirus-associated infectious mononucleosis-like syndrome accompanied by transient monoclonal expansion of CD8+ T-cells].
abstract: Most cases of infectious mononucleosis (IM) are caused by Epstein-Barr virus (EBV). Other pathogens have been reported to cause heterophile-negative mononucleosis-like syndrome, including cytomegalovirus (CMV) and human immunodeficiency virus type-1 (HIV-1). Primary CMV infection is often asymptomatic in immunocompetent individuals. In this article, we describe a patient with prolonged fever and fatigue, who developed transient monoclonal CD8+ T-cell lymphocytosis after primary CMV infection. Monoclonal gene rearrangement of T-cell receptor (TCR) beta locus was transiently detected in DNA from peripheral lymphocytes. Monoclonal rearrangement and atypical lymphocytosis disappeared after treatment with anti-viral agents. These observations imply that monoclonal expansion of T-cells could be a reactive phenomenon of primary CMV infection and TCR gene rearrangement is not specific for malignancy. Physicians should carefully follow patients with monoclonal expansion of CD8+ T-cells after CMV-IM in order to rule out T cell malignancy.
authors.affiliation: Department of Hematology, Kokura Memorial Hospital.
authors.forename: Akihito
authors.initials: A
authors.lastname: Yonezawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Onaka
authors.forename: Kazunori
authors.initials: K
authors.lastname: Imada
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage; D018414:CD8-Positive T-Lymphocytes; D003586:Cytomegalovirus Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D015774:Ganciclovir / Q000008:administration & dosage; D015329:Gene Rearrangement, T-Lymphocyte; D006801:Humans; D007244:Infectious Mononucleosis / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D008218:Lymphocytosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir