Peripheral blood leukocyte counts in cytomegalovirus infected heart transplant patients: impact of acute disease versus subclinical infection.

Peripheral blood leukocyte counts in cytomegalovirus infected heart transplant patients: impact of acute disease versus subclinical infection. Research Abstract Details 

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Peripheral blood leukocyte counts in cytomegalovirus infected heart transplant patients: impact of acute disease versus subclinical infection. Abstract Text:

Margaret E Cooke,Luciano Potena,Helen Luikart,Hannah A Valantine,

BACKGROUND: Cytomegalovirus (CMV)-associated leucopenia in heart transplant patients is poorly characterized. METHODS: We conducted a retrospective analysis of timing, degree, and type of leukopenia in four groups of patients: cases (n=20); controls (n=20); subclinical early infection (n=21), and subclinical late infection (n=22). In the cases, white blood cells (WBC) count at diagnosis was compared to prediagnosis; and cases were compared to controls. Subclinical cases (early and late) were identified by measurement of CMV DNA in peripheral blood mononucleocytes, and WBC was compared to those of the cases and controls. RESULTS: First, in human heart transplant recipients the total leukocyte count decreased prior to the time of diagnosis of CMV disease: cases: 5.4+/-2.1 x 10/microL vs. 3.7+/-2.1x10/muL (P<0.01); subclinical early: 8.1+/-4.1 x 10/microL vs. 6.9+/-1.6 x 10/microL (P<0.01). Second, the leukocyte populations most reduced during CMV disease are the neutrophils: 4.4 x 10/microL (78%) to 2.5 x 10/microL (69%) (P<0.05), and monocytes 0.6 x 10/microL (11%) to 0.3 x 10/microL (7.5%) (P<0.05). Third, the reduction in leukocyte count that occurs during CMV disease appears to be independent of immunosuppressive therapy (using cyclosporine A, mycophenolate mofetil, or azathioprine and prednisone). Finally, subclinical CMV infection in stable long-term heart transplant patients without disease is unassociated with a reduction in the leukocyte count. CONCLUSIONS: Aside from implications for early diagnosis, CMV-associated decrease in monocytes is important because viral infections like Epstein-Barr virus cause monocytosis. The absence of leucopenia in subclinical late infections is a new important finding.

Peripheral blood leukocyte counts in cytomegalovirus infected heart transplant patients: impact of acute disease versus subclinical infection. Publishing Authors By Initials

ME Cooke,L Potena,H Luikart,HA Valantine,

For similar investigative techniques: epidemiologic methods: epidemiologic study characteristics as topic: epidemiologic studies: case-control studies: retrospective studies research abstracts see: investigative techniques: epidemiologic methods: epidemiologic study characteristics as topic: epidemiologic studies: case-control studies: retrospective studies research

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Peripheral blood leukocyte counts in cytomegalovirus infected heart transplant patients: impact of acute disease versus subclinical infection. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Transplantation

VOLUME: 82

Page Numbers: 1419-24

Journal Abbreviation: Transplantation

ISSN: 0041-1337

DAY: 15

MONTH: Dec

YEAR: 2006

Peripheral blood leukocyte counts in cytomegalovirus infected heart transplant patients: impact of acute disease versus subclinical infection. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 132144

Peripheral blood leukocyte counts in cytomegalovirus infected heart transplant patients: impact of acute disease versus subclinical infection. Keywords Mesh Terms:

KEYWORDS: Retrospective Studies

MESH TERMS: analogs & derivatives

Chemical & Substance for Abstract: Peripheral blood leukocyte counts in cytomegalovirus infected heart transplant patients: impact of acute disease versus subclinical infection. Information

Substance Name: Azathioprine

Registry Number: 446-86-6

Grant and Affiliation Information for Peripheral blood leukocyte counts in cytomegalovirus infected heart transplant patients: impact of acute disease versus subclinical infection.

AFFILIATION: Heart Transplantation Unit, Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford, CA 94305, USA.

Country: United States

AGENCY: United States NIAID

GRANT: P01 AI-50153

ACRONYM: AI

MEDLINETA: Transplantation

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