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8743

Cytomegalovirus Retininis in a Patient with Waldenstrom Macroglobulinemia

Article

Last updated: 03 Jan 2025

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Tags

Infectious diseases

Abstract

A 62-years-old woman presented with microcytic hypochromic anemia, diffuse adenopathy, , and hepatosplenomegaly, was diagnosed as having Waldenst?m Macroglobulinemia by blood serum electrophoresis which detected a IgM-KAPPA monoclonal gammopathy, besides the results of  immuno-phenotypic characteristics of neoplastic B-lymphocytes present in bone marrow positive for CD19, CD20, FMC7, CD79; and not reactive for CD23, CD5 and CD38. MYD88 mutation was absent. The patient underwent a week intermittent chemotherapy (oral scheme: Predinisone Session [CurrentTestPartID] mg and Chlorambucil 2 mg during 5 months) and then, without adequate therapeutic response, it was reset including intra-venous anti-CD20 monoclonal immunoglobulin (Rituximab, for 4 months). The patient had a good response to the therapy. However, almost a year after Rituximab scheme started, patient complained of sudden decrease of visual acuity (20/200) according to the Snellen chart with floaters, only in the left eye. CD4 T cell count was 205 cells/mm3, relatively reduced when compared to a health person because of the chronic use of immunosuppressant drugs and the down modulation due to the inflammatory stress state seen at a hematological lymphoproliferative disease. Fundoscopy findings were compatible with CMV retinitis , confirmed by CMV-DNA PCR in plasma samples with a high viremia (3.102 copies/mL). Plasma cytokines were measured to see the inflammatory response Intravenous Ganciclovir 500mg every 12 hours for 2 weeks was administered. Granulocyte colony-stimulating factor was used to manage neutropenia. Visual acuity improvement was observed (20/40).

DOI

10.21608/aeji.2018.8743

Authors

First Name

Felipe

Last Name

Rodrigues

MiddleName

Tavares

Affiliation

Graduate Student of Escola de Medicina e Cirurgia do Rio de Janeiro- UNIRIO, Brazil

Email

medftr@yahoo.com.br

City

-

Orcid

-

First Name

Alexandre

Last Name

Paiva

MiddleName

de Carvalho

Affiliation

Physician at Hospital Universit?rio Gafrée e Guinle- UNIRIO, Brazil

Email

-

City

-

Orcid

-

First Name

Catherine

Last Name

Valdez

MiddleName

da Cal

Affiliation

Physician at Hospital Universit?rio Gafrée e Guinle- UNIRIO, Brazil

Email

-

City

-

Orcid

-

First Name

Cleonice

Last Name

de Melo Bento

MiddleName

Alves

Affiliation

Professor of Universidade Federal do Estado do Rio de Janeiro – UNIRIO, Brazil.

Email

-

City

-

Orcid

-

First Name

Regis

Last Name

de Andrade

MiddleName

Mariano

Affiliation

Professor of Universidade Federal do Estado do Rio de Janeiro – UNIRIO, Brazil.

Email

-

City

-

Orcid

-

Volume

8

Article Issue

2

Related Issue

1682

Issue Date

2018-06-01

Receive Date

2018-07-06

Publish Date

2018-06-01

Page Start

103

Page End

104

Print ISSN

2090-7613

Online ISSN

2090-7184

Article File

AEJI_Volume 8_Issue 2_Pages 103-104.pdf

PDF . 324.9kB

Link

https://aeji.journals.ekb.eg/article_8743.html

Detail API

https://aeji.journals.ekb.eg/service?article_code=8743

Order

6

Type

Case report

Type Code

622

Publication Type

Journal

Publication Title

Afro-Egyptian Journal of Infectious and Endemic Diseases

Publication Link

https://aeji.journals.ekb.eg/

MainTitle

Cytomegalovirus Retininis in a Patient with Waldenstrom Macroglobulinemia

Details

Type

Article

Created At

22 Jan 2023