Polyarteritis nodosa and cytomegalovirus: Diagnosis by polymerase chain reaction

We investigated the occurence of an active cytomegalovirus (CMV) infection in patients with polyarteritis nodosa (PAN). Eleven patients with PAN were screened for the presence of CMV-DNA in their blood using the polymerase ch ain reaction (PCR). Serum anti-CMV Ige and anti-CMV IgM antibodies were det ermined by enzyme-linked immunosorbent assays (ELISA). The ELISA for IgM wa s negative in all cases whereas that for IgG was positive in eight cases. O nly one patient was positive for CMV-DNA by PCR. He presented with myalgia, polyarthralgia, fever and weight loss, suggesting PAN activity. CMV infect ion was uncommon in our series of patients with PAN, despite disease activi ty and immunosuppressor therapy. The finding of a transient CMV infection i n one case at the beginning of PAN activity suggests that CMV may be involv ed in the pathogenesis of PAN.