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Hypogammaglobulinemia associated with cytomegalovirus pneumonia

P A Greenberger1, C L Walker, T E Fitzsimons

  • 1Section of Allergy-Immunology, Northwestern University Medical School, Chicago, IL 60611.

The Journal of Infectious Diseases
|March 1, 1991
PubMed

Insights

Cytomegalovirus (CMV) pneumonia caused temporary hypogammaglobulinemia and severe T-lymphocyte depletion in a hemodialysis patient. Immunoglobulin levels normalized as the CMV infection resolved, highlighting a rare association.

Area of Science:

  • Immunology
  • Virology
  • Hematology

Background:

  • Cytomegalovirus (CMV) infection can cause various clinical manifestations.
  • Hypogammaglobulinemia is a condition characterized by abnormally low levels of immunoglobulins.
  • T-lymphocyte populations play a crucial role in immune regulation.

Observation:

  • A 66-year-old female patient on hemodialysis presented with CMV pneumonia.
  • Prior to pneumonia, the patient had normal immunoglobulin levels (IgG, IgA, IgM).
  • During CMV pneumonia, significant reductions in IgG, IgA, and IgM were observed.

Findings:

  • The patient experienced a profound drop in total lymphocytes from 3048/mm3 to 212/mm3.
  • Specific T-lymphocyte subsets, including CD4+CD45- and CD8+ cells, were markedly reduced.
  • Serum immunoglobulin concentrations returned to normal levels following resolution of CMV pneumonia.

Implications:

  • This case suggests a potential causal link between CMV infection and acquired hypogammaglobulinemia.
  • The profound lymphopenia observed underscores the significant impact of CMV on the immune system.
  • Further research is warranted to elucidate the mechanisms underlying CMV-induced hypogammaglobulinemia.

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