MAN-CHIU POON, M.D.; ALAN LANDAY, Ph.D.; ED F. PRASTHOFER, M.D.; SERGIO STAGNO, M.D.
A previously healthy patient with classic hemophilia who was on a home infusion program with factor VIII concentrates developed an acquired immunodeficiency syndrome manifested by a dramatic weight loss (47 kg over 12 months), lassitude, transient thrombocytopenia, and opportunistic infections with Varicella zoster, Pneumocystis carinii, and Mycobacterium avium-intracellulare. The patient was not homosexual and had no history of intravenous drug abuse. Immunologic studies showed a persistent lymphopenia with reversal of helper/ suppressor-cytotoxic T-lymphocyte ratios, depression of human natural killer cell function, and in-vitro lymphocyte proliferative responses to mitogens and viral antigens. Serum IgA levels were also elevated. Serum antibodies against cytomegalovirus, herpes simplex viruses 1 and 2, Epstein-Barr virus, Varicella zoster, and hepatitis B virus were shown, suggesting previous infection by these agents. Reactivation of cytomegalovirus infection was suggested by a rising titer of antibodies against cytomegalovirus concurrent with Pneumocystis pneumonia, and was confirmed by the growth of this virus in a throat culture 2 months later.
POON M, LANDAY A, PRASTHOFER EF, et al. Acquired Immunodeficiency Syndrome with Pneumocystis carinii Pneumonia and Mycobacterium avium-intracellulare Infection in a Previously Healthy Patient with Classic Hemophilia: Clinical, Immunologic, and Virologic Findings. Ann Intern Med. 1983;98:287–290. doi: 10.7326/0003-4819-98-3-287
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Published: Ann Intern Med. 1983;98(3):287-290.
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