Cytomegalovirus infection in systemic necrotizing vasculitis: causative agent or opportunistic infection?

摘要: We report on a 69-year-old woman who presented with myalgia, hearing impairment, fever, night sweats, weight loss, muscular weakness, paresthesia, hypesthesia, and hypalgesia. Sural nerve biopsy showed demyelinative axonal polyneuropathy due to necrotizing vasculitis fibrinoid necrosis. A positive test for antineutrophil cytoplasmic antibodies (ANCA) perinuclear immunofluorescence pattern directed against myeloperoxidase was more suggestive of microscopic polyangiitis (MPA) than polyarteritis nodosa (PAN), the possible differential diagnoses. In addition, tests cytomegalovirus (CMV) (immunoglobulin (Ig)M IgG) detection CMV-DNA in sputum specimens by polymerase chain reaction (PCR) were indicative active CMV infection. Treatment ganciclovir anti-CMV immunoglobulin addition prednisolone medication 6 months resulted rapid improvement clinical symptoms without relapse. infection has been described be related ANCA-associated non-immunocompromized patients may either causative agent or an opportunistic Identification viral etiology atypical vasculitides lead different, less aggressive treatment approaches, including antiviral therapy.