Viruses have long been held to be of pathogenetic importance in the evolution of autoimmune connective tissue disease. We describe 7 adults who developed cutaneous connective tissue disease stigmata in temporal association with recent cytomegalovirus (CMV) infection but without the classic cytopathic changes of CMV infection. We examined 7 adults with clinical presentations encompassing cutaneous vasculitis in 4 and scleroderma in 3. In all 7 patients, there was either IgM seropositivity for CMV and/or CMV DNA isolation from peripheral blood. Although no CMV inclusions were seen, in situ hybridization studies revealed very focal CMV RNA transcript expression with localization mainly to the endothelium. The patients with vasculitis treated with ganciclovir had improvement or resolution of symptoms, whereas only 1 patient with scleroderma received antiviral therapy, without benefit. Another scleroderma patient responded to infliximab therapy. Abortive/partial CMV reactivation can be associated with a syndrome complex mimicking and/or triggering a primary immune-based cutaneous microvascular injury syndrome. Antiviral therapy appears to be of therapeutic value in those cases associated with active necrotizing vasculitic changes. The role of tumor necrosis factor alpha blockers in scleroderma cases temporally associated with CMV infection requires further evaluation. (c) 2007 Published by Elsevier Inc.
|Anno di pubblicazione:||2007|
|Titolo:||Cytomegalovirus-associated cutaneous vasculopathy and scleroderma sans inclusion body change|
|Autore/i:||Magro CM; Crowson AN; Ferri C|
|Codice identificativo ISI:||WOS:000243267000005|
|Codice identificativo Scopus:||2-s2.0-33845318243|
|Citazione:||Cytomegalovirus-associated cutaneous vasculopathy and scleroderma sans inclusion body change / Magro CM; Crowson AN; Ferri C. - In: HUMAN PATHOLOGY. - ISSN 0046-8177. - STAMPA. - 38(2007), pp. 42-49.|
|Tipologia||Articolo su rivista|
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