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Arch Intern Med. 2001;161:2149-2150.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Severe blood coagulation disorders are rare complications during primary cytomegalovirus (CMV) infection. We describe 2 patients who were receiving azathioprine treatment when they developed blood coagulation disorders (thrombotic microangiopathy in one patient and disseminated intravascular coagulation in the other) during primary CMV infection. We discuss herein the mechanisms underlying these complications in CMV disease and emphasize the importance of a prompt diagnosis for rapid and specific treatment, especially in immunocompromised patients.

Report of Cases

Case 1

A 56-year-old woman was hospitalized in 1995 for persistent fever. She was known to have multiple sclerosis that was being managed with azathioprine. On physical examination, a 40°C temperature and bilateral pulmonary crackling rales were revealed.

Laboratory findings disclosed microangiopathic hemolytic anemia (hemoglobin level, 10.6 g/dL; schistocytes; haptoglobin level, 80 mg/dL; lactate dehydrogenase level, 1960 IU/L; and a negative direct Coombs test result), thrombocytopenia (thrombocyte count, 122 x 10³/µL), leukopenia (leukocyte count, 3200 x 10³/µL), inflammation, and . . . [Full Text of this Article]

Case 2

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