Disseminated cytomegalovirus disease in a patient with systemic lupus erythematosus not undergoing immunosuppressive therapy

We describe a case of cytomegalovirus (CMV) infection in a 25-year-old woma n with a 3-year history of systemic lupus erythematosus (SLE) with persiste ntly high disease activity, who had not received immunosuppressive therapy. Disseminated CMV infection presented with upper gastrointestinal bleeding, high fever, respiratory distress, leukopenia, and thrombocytopenia. The CM V infection was successfully treated with combined antiviral and immunoglob ulin therapy, and the SLE activity decreased concomitantly. CMV disease is closely related to host immunosuppression, primarily T-lymphocyte dysfuncti on. This case should highlight the relationship between clinically signific ant CMV disease and compromised immunity in patients with active SLE who ar e not receiving immunosuppressive therapy.