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CASE REPORT
Cytomegalovirus infection with pulmonary embolism, splenic vein thrombosis and monoclonal gammopathy of undetermined significance: a case and systematic review
  1. Esther de Rooij1,
  2. Rolf Verheul2,
  3. Mariëlle de Vreede3 and
  4. Ype de Jong1
  1. 1 Department of Internal Medicine, Haaglanden Medical Center, Den Haag, The Netherlands
  2. 2 Department of Clinical Chemistry and Laboratory Medicine, LabWest, Haaglanden Medical Center, Den Haag, The Netherlands
  3. 3 Department of Haematology, Haaglanden Medical Center, Den Haag, The Netherlands
  1. Correspondence to Dr Ype de Jong, ypedejong{at}hotmail.com

Abstract

A 62-year-old immunocompetent woman was admitted with cytomegalovirus (CMV) infection, pulmonary embolism, splenic vein thrombosis and monoclonal gammopathy of undetermined significance (MGUS). Anticoagulation therapy was started. Two months later, seroconversion of CMV IgM to IgG was observed, while the monoclonal protein was no longer detectable. This suggests a relationship between acute CMV infection, transient MGUS and thrombosis. In accordance with current best practice guidelines for provoked venous thromboembolism (VTE), anticoagulation therapy could be discontinued after 3 months instead of 6 for unprovoked VTE, thereby reducing unnecessary time at risk of bleeding complications. While the relationships between CMV and both MGUS and thrombosis have been described independently, we are first to describe these three conditions occurring simultaneously.Furthermore, we provide a systematic review on the relation between CMV, MGUS and thrombosis.

  • venous thromboembolism
  • hepatitis other
  • haematology (Incl blood transfusion)
  • malignant and benign haematology
  • portal vein
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Footnotes

  • Contributors EdR and YdJ wrote the article. RV and MdV peer-reviewed and provided valuable feedback.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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