Unusual lymphocytosis with systemic lupus erythematosus

Indian J Pediatr. 2008 Jul;75(7):748-50. doi: 10.1007/s12098-008-0142-2. Epub 2008 Aug 21.

Abstract

A 15-year-old boy with systemic lupus erythematosus, who on a follow up visit complained of recurrent episodes of fever, easy fatiguability, and seizures. Investigations revealed lymphocytosis (95%), anemia, and a positive PCR for cytomegalovirus (CMV). Electron microscopy of the lymphocytes revealed intranuclear inclusion bodies supporting the diagnosis of CMV infection. The child was treated with ganciclovir and discharged. At discharge the child was afebrile. However, lymphocytosis persisted even after 9 months of discharge. Repeated screening for possible lymphoreticular malignancy was negative. It is likely that lymphocytosis in this child was due to persistence of CMV infection in host cells leading to continued provocation of the host immune system.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anemia / complications
  • Antiviral Agents / therapeutic use
  • Cytomegalovirus / isolation & purification*
  • Cytomegalovirus Infections / diagnosis
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / virology*
  • Flow Cytometry
  • Ganciclovir / therapeutic use
  • Humans
  • Lupus Erythematosus, Systemic / blood
  • Lupus Erythematosus, Systemic / complications*
  • Lymphocytes / blood
  • Lymphocytosis / complications*
  • Lymphocytosis / diagnosis
  • Male

Substances

  • Antiviral Agents
  • Ganciclovir