Phantom cytomegalovirus infection in vasculitis patients : what it means and what to do

We report our experience and hypothesis on the diagnosis and treatment of patients with vasculitis who are simultaneously diagnosed with serum-positive cytomegalovirus (CMV) immunoglobulin (Ig)M antibodies and negative CMV DNA polymerase chain reaction (PCR). It remains unknown how to treat this kin...

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Bibliographic Details
Published in:Rheumatology international 2005-10, Vol.25 (8), p.631-632
Main Authors: KATSANOS, Konstantinos H, KOSTOULA, Aggeliki, KATOPODIS, Konstantinos P, SIAMOPOULOS, Kostas C
Format: Article
Language:English
Subjects:
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antibodies, Viral - blood
Antiviral agents
Antiviral Agents - therapeutic use
Biological and medical sciences
Cytomegalovirus - immunology
Cytomegalovirus - isolation & purification
Cytomegalovirus Infections - blood
Cytomegalovirus Infections - complications
Cytomegalovirus Infections - drug therapy
DNA, Viral - blood
Ganciclovir - therapeutic use
Humans
Immunoglobulin M
Infections
Medical sciences
Pharmacology. Drug treatments
Polymerase Chain Reaction
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Treatment Outcome
Vasculitis - complications
Vasculitis - drug therapy
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Summary:We report our experience and hypothesis on the diagnosis and treatment of patients with vasculitis who are simultaneously diagnosed with serum-positive cytomegalovirus (CMV) immunoglobulin (Ig)M antibodies and negative CMV DNA polymerase chain reaction (PCR). It remains unknown how to treat this kind of "phantom" CMV infection. In a patient diagnosed with Henoch-Schönlein vasculitis, CMV IgM titers were increased while angiitis and renal function deteriorated. Empiric treatment of phantom CMV infection with ganciclovir in this CMV IgM-positive and PCR-negative patient resulted in complete vasculitis remission, serum CMV antibody seroconversion, and renal function improvement. These results imply something more than coincidence.
ISSN:0172-8172
1437-160X
DOI:10.1007/s00296-004-0522-5