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Measles giant cell pneumonia in childhood leukemia in remission
Abstract:
A four-year old girl had acute lymphoblastic leukemia in remission with immunosupressive chemotherapy and complicated giant cell pneumonia. Investigations by light and electron microscopy and immunoperoxidase study of autopsy material disclosed measles virus nature of the penumonia, although there was no typical rash of the disease. Similar giant cells were seen in the gastric and colon mucosa, and the other of Warthin-Finkeldey type in the spleen, and lymph nodes of pulmonary hiluses. To the best of our knowledge, this is the first discription of gastric giant cells with inclusion of measles virus.
Insights
Giant cell pneumonia in a child with acute lymphoblastic leukemia was caused by measles virus. This study identifies measles virus in gastric and colon tissues, a novel finding.
Area of Science:
- Pediatric Oncology
- Virology
- Pathology
Background:
- A 4-year-old girl with acute lymphoblastic leukemia (ALL) in remission, undergoing immunosuppressive chemotherapy, developed giant cell pneumonia.
- The patient presented with respiratory distress, a known complication in immunocompromised individuals.
Observation:
- Autopsy revealed multinucleated giant cells in the lungs, characteristic of viral pneumonia.
- Microscopic examination identified measles virus within these giant cells, despite the absence of a typical measles rash.
- Similar giant cells, some of the Warthin-Finkeldey type, were observed in the gastric and colon mucosa, spleen, and lymph nodes.
Findings:
- The pulmonary pneumonia was confirmed to be of measles virus etiology through light microscopy, electron microscopy, and immunoperoxidase studies.
- This is the first reported instance of measles virus inclusion bodies within gastric giant cells.
- The presence of Warthin-Finkeldey changes in lymphoid tissues further supports a systemic measles virus infection.
Implications:
- This case highlights the potential for atypical measles virus presentations, particularly in immunocompromised pediatric patients.
- It underscores the importance of considering viral etiologies, like measles, in severe pneumonia unresponsive to standard treatments.
- The identification of gastric and colonic involvement expands the understanding of the gastrointestinal manifestations of measles virus infection.