ABSTRACT
Posttransplantation cytomegalovirus (CMV) disease typically occurs 1-4 months after solid-organ transplantation. The case definition invariably includes unexplained fever for > or =3 days, often with leukopenia. Late and atypical presentation of CMV disease has been rarely reported. Five cases of late and atypical CMV disease in heart (n = 1), liver (n = 1), and kidney (n = 3) transplant recipients occurred within a 4-month period in early 1999. These patients presented at a median of 25 months after organ transplantation (range, 6 months to 22 years). Atypical findings included absence of fever in 3 patients, elevated white blood cell counts in 4 patients, and normal platelet counts in 4 patients. Four patients were at risk for primary CMV infection, and 3 received ganciclovir prophylaxis for 3 months. One patients was treated for rejection, and 2 patients had induction muromonab-CD3 (Orthclone; Orthobiotech). Two of the patients had pulmonary CMV disease, but neither of these patients had hypoxia. Two patients had enterocolitis, one of whom had chronic colitis for a year. These cases may represent a changing epidemiology and clinical presentation of CMV disease in solid-organ transplant recipients in an era of changing immunosuppression and improved CMV disease prevention in the early posttransplantation period.
Subject(s)
Cytomegalovirus Infections/epidemiology , Cytomegalovirus Infections/physiopathology , Organ Transplantation/adverse effects , Adult , Cytomegalovirus/immunology , Cytomegalovirus/isolation & purification , Cytomegalovirus Infections/virology , Female , Humans , Male , Time FactorsABSTRACT
Peripheral venous blood lymphocytes were defined, in 21 subjects with essential hypertension and 20 controls, on the basis of reactivity with monoclonal antibodies OKT3, OKT4, OKT8, OK1Ia. Total lymphocyte count, OKT3+ and OKT4+ cells percentage were similar in normal and hypertensive. OKT8+ cells percentage was significantly lower only in hypertensive stage II and III patients (WHO classification).
Subject(s)
Hypertension/immunology , Lymphocytes/immunology , Adult , Aged , Antibodies, Monoclonal , Female , Humans , Leukocyte Count , Male , Middle AgedABSTRACT
M, G, and A immunoglobulins as well as C3 and C4 complement fractions were determined in 20 patients with essential hypertension: all the values were in the normal range. Nearly half of the patients had an abnormally high value of circulating immune complexes as determined with Clq binding assay and/or with CIC test. The rise of circulating immune complexes is not related to the stage of arterial hypertension.