Cytomegalovirus-associated pulmonary septal capillary injury sine inclusion body change: A distinctive cause of occult or macroscopic pulmonary hemorrhage in the immunocompetent host Article Report uri icon


MeSH Major

  • Lymphoma, T-Cell, Cutaneous
  • Precancerous Conditions
  • Skin Neoplasms


  • The authors describe four patients with symptomatic lung disease morphologically representing a septal capillary injury syndrome temporally associated with serologic and culture evidence of active cytomegalovirus (CMV) infection but without classic cytopathic changes. The authors conducted a thorough review of clinical data, microscopic examination, and in situ hybridization to detect CMV mRNA encoding immediate early protein. The assay detects transcripts that encode early and immediate early proteins. In two cases additional tissue was available for direct immunofluorescent studies. The disease process in each of the patients was morphologically indistinguishable from the pattern of organ injury associated with autoimmune diseases including a small vessel microvascular injury syndrome involving skin and lung and immune complex- mediated glomerulonephritis. Cytopenias were seen in all cases, most commonly thrombocytopenia. All treated patients demonstrated improvement on combined ganciclovir and low-dose steroid therapy. CMV infection may be of pathogenetic importance in some cases of alveolar hemorrhage, especially when accompanied by peripheral blood cytopenia in otherwise healthy patients and if clinical worsening occurs in the setting of a traditional immunosuppressive regimen typically used to treat vasculitis.

publication date

  • September 2005



  • Report


Digital Object Identifier (DOI)

  • 10.1097/01.pai.0000137911.39736.95

PubMed ID

  • 16082254

Additional Document Info

start page

  • 268

end page

  • 72


  • 13


  • 3