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Cytomegalovirus Infection In Patients Receiving Long-Term Hemodialysis

Tooru Nakao, MD; Shigeru Ikeda, MD; Hiroshi Shiono, MD; Masahiro Suzuki, MD
JAMA. 1971;217(5):697-698. doi:10.1001/jama.1971.03190050153023.
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To the Editor.—  In their communication (212:1350, 1970), Siddiqui et al reported that causes of death in patients receiving long-term hemodialysis were intracranial hemorrhage, convulsive disorders of unknown etiology, hyperkalemia, infection, and others. Attention was concentrated on bacterial infection, but viral infection, especially cytomegalovirus (CMV) infection, must be considered, as in the case of a 13-year-old boy who suffered from chronic glomerulonephritis and was treated by hemodialysis from January 1970 onward. Complement-fixing antibody titers against CMV rose significantly in November. At that time, serum transaminase levels were elevated, but no clinical illness was seen. Immunofluorescent antibody titers to Epstein-Barr virus were not changed and Australia antigen was negative throughout the period of hemodialysis.Elevation of serum transaminase levels in this case was thought to be due to CMV infection. It is known that asymptomatic CMV infection may follow blood transfusion.1,2 Since the report by Hanshaw et al,3

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