TY - JOUR
T1 - Multiorgan involvement due to cytomegalovirus infection in AIDS
AU - Majumder, Shounak
AU - Mandal, Sanjay K.
AU - Bandyopadhyay, Dipanjan
AU - Chowdhury, Subhasis Roy
AU - Chakraborty, Partha P.
AU - Mitra, K.
PY - 2007/2
Y1 - 2007/2
N2 - Cytomegalovirus (CMV) infection is a relatively late complication of AIDS. Like other viruses contributing to comorbidity of HIV infection, cytomegalovirus has the propensity to cause multiorgan involvement. We report the case of a 34-year-old seropositive man who presented with bilateral lower limb weakness and symptomatic pallor. He was already on antiretroviral drugs for a month prior to presentation. Detailed clinical examination and laboratory investigations revealed cytomegalovirus polyradiculoneuropathy associated with bone marrow dysplasia. Dysplasia of haematopoeitic cell lines occurs in 30% to 70% of HIV infected patients, and is often indistinguishable from myelodysplastic syndrome. However, in our case, the bone marrow picture reverted back to normal with treatment of the CMV infection, pointing to a possible role of CMV as the causative agent of bone marrow dysplasia. Moreover, CMV has been incriminated as a pathogen producing the immune reconstitution inflammatory syndrome. The onset of the disease in our case one month after initiation of HAART strongly raises the possibility of this being a case of CMV related IRIS. This is the first reported case where IRIS has presented with CMV polyradiculoneuropathy and bone marrow dysplasia. We would like to highlight that in today's era of HIV care, clinicians should be aware of the possibility of multiorgan involvement by CMV, for appropriate management of this disease in the background of AIDS.
AB - Cytomegalovirus (CMV) infection is a relatively late complication of AIDS. Like other viruses contributing to comorbidity of HIV infection, cytomegalovirus has the propensity to cause multiorgan involvement. We report the case of a 34-year-old seropositive man who presented with bilateral lower limb weakness and symptomatic pallor. He was already on antiretroviral drugs for a month prior to presentation. Detailed clinical examination and laboratory investigations revealed cytomegalovirus polyradiculoneuropathy associated with bone marrow dysplasia. Dysplasia of haematopoeitic cell lines occurs in 30% to 70% of HIV infected patients, and is often indistinguishable from myelodysplastic syndrome. However, in our case, the bone marrow picture reverted back to normal with treatment of the CMV infection, pointing to a possible role of CMV as the causative agent of bone marrow dysplasia. Moreover, CMV has been incriminated as a pathogen producing the immune reconstitution inflammatory syndrome. The onset of the disease in our case one month after initiation of HAART strongly raises the possibility of this being a case of CMV related IRIS. This is the first reported case where IRIS has presented with CMV polyradiculoneuropathy and bone marrow dysplasia. We would like to highlight that in today's era of HIV care, clinicians should be aware of the possibility of multiorgan involvement by CMV, for appropriate management of this disease in the background of AIDS.
KW - AIDS
KW - Cytomegalovirus
KW - Multiorgan involvement
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U2 - 10.1590/S1413-86702007000100039
DO - 10.1590/S1413-86702007000100039
M3 - Article
C2 - 17625753
AN - SCOPUS:34347397416
SN - 1413-8670
VL - 11
SP - 176
EP - 178
JO - Brazilian Journal of Infectious Diseases
JF - Brazilian Journal of Infectious Diseases
IS - 1
ER -