Hematological and immunological signs of CMV infection in hospitalized non-immunocompromised adult.

Purpose. - Cytomegalovirus (CMV) infection in non-immunocompromised adults can sometimes induce hematological and immunological disorders that may mis lead diagnosis. Methods. - Case reports of hospitalized non-immunocompromised adults with p ositive serology for CMV including the presence of immunoglobulin M or sero conversion were assessed in a retrospective study (1981-1998). We focused o n clinical and biological abnormalities showing the role of CMV in disrupti on of functioning of hematological and immunological systems. Results. - Among 115 patients lymphoma-like syndrome with large adenopathie s and/or splenomegaly was diagnosed in eight patients uncovering underlying CMV infection. Lymphoma was accompanied by hematoma in two patients. Three patients presented leg purpura (with thrombotic thrombocytopenic purpura i n one case), one patient had cutaneous vasculitis and on other a Still's di sease. Blood abnormalities were mononucleosis (64%), anemia (20%), and thro mbopenia (25%) often of peripheral or hemolytic origin or due to hypersplen ia. Electrophoresis of serum proteins showed an increase in immune globulin s in 56% of the cases and monoclonal abnormality in nine cases. Immunologic al assessment was conducted in 18 patients. At least one abnormality was de picted in ten patients, consisting of either antinuclear, anti-platelet or anti smooth muscle antibodies cryoglobulinemia, rheumatoid factor, or reduc ed complement fixation. Conclusion. - Testing for CMV infection can be of value in case of blood or immunological disorders associated with clinical or biological signs. Alth ough hematological disorders occur early, they are rarely severe. Immunolog ical disorders are rarely symptomatic, but often raise issues regarding the potential genesis of immune diseases in at-risk patients. (C) 2000 Edition s scientifiques et medicales Elsevier SAS.