TY - JOUR
T1 - Persistent cytomegalovirus infection
T2 - Association with profound immunodeficiency and treatment with interferon
AU - Pahwa, Savita
AU - Kirkpatrick, Dahlia
AU - Ching, Clara
AU - Lopez, Carlos
AU - Pahwa, Rajendra
AU - Smithwick, Elizabeth
AU - O'Reilly, Richard
AU - August, Charles
AU - Pasquariello, Patrick
AU - Good, Robert A.
N1 - Funding Information:
We are grateful to all the physicians, nurses, scientists, and other laboratory personnel who helped in the investigations and management of this patient. We give special thanks to Dr. A. Korval, Dr. N. Kapoor, Dr. P. Meyers, Dr. S. Cunningham-Rundles and Dr. B. Koziner for their efforts. Interferon was supplied by the National Institutes of Health and Levamisole by Janssen Pharmaceuticals. Secretarial assistance of Ms. A. Abbatiello is deeply appreciated. This work was aided by grants from the March of Dimes, 7-789, AI 19495, NS 18851, and the Zelda Radow Weintraub Cancer Fund.
PY - 1983/7
Y1 - 1983/7
N2 - Cytomegalovirus (CMV) was repeatedly isolated from urine and saliva of a 20-month-old male child with recurrent episodes of pneumonia, high fever, rash, lymphadenopathy, oral ulceration, and neutropenia. Immunologic evaluation revealed decreased serum IgG and IgA, increased IgM, depressed T- and B-lymphocyte functions, and decreased natural killer (NK) activity for herpes simplex-type I virus-infected targets. NK activity was augmented following exposure of the patient's lymphocytes to interferon (IF) in vitro. The child was treated with interferon (four courses, dosage varying from 2 million U/day to 1 million U three times/week for periods of 10, 28, 80, and 67 days, respectively, interspersed over 9 months) and hyperimmune plasma infusions every 3 weeks. Toward the end of interferon therapy oral Levamisole was started and a feeding gastrostomy was inserted to provide nutritional support. Clinical recovery was associated with reversal of immunologic abnormalities except for the hypogammaglobulinemia. Aggressive antiviral therapy (e.g., with IF) followed by immunostimulation (e.g., with Levamisole) may prove effective in controlling certain viral infections in immunodeficiency disorders.
AB - Cytomegalovirus (CMV) was repeatedly isolated from urine and saliva of a 20-month-old male child with recurrent episodes of pneumonia, high fever, rash, lymphadenopathy, oral ulceration, and neutropenia. Immunologic evaluation revealed decreased serum IgG and IgA, increased IgM, depressed T- and B-lymphocyte functions, and decreased natural killer (NK) activity for herpes simplex-type I virus-infected targets. NK activity was augmented following exposure of the patient's lymphocytes to interferon (IF) in vitro. The child was treated with interferon (four courses, dosage varying from 2 million U/day to 1 million U three times/week for periods of 10, 28, 80, and 67 days, respectively, interspersed over 9 months) and hyperimmune plasma infusions every 3 weeks. Toward the end of interferon therapy oral Levamisole was started and a feeding gastrostomy was inserted to provide nutritional support. Clinical recovery was associated with reversal of immunologic abnormalities except for the hypogammaglobulinemia. Aggressive antiviral therapy (e.g., with IF) followed by immunostimulation (e.g., with Levamisole) may prove effective in controlling certain viral infections in immunodeficiency disorders.
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U2 - 10.1016/0090-1229(83)90190-3
DO - 10.1016/0090-1229(83)90190-3
M3 - Article
C2 - 6307574
AN - SCOPUS:0020576619
VL - 28
SP - 77
EP - 89
JO - Clinical Immunology
JF - Clinical Immunology
SN - 1521-6616
IS - 1
ER -