Inherited and acquired predispositions for thrombosis in immunocompetent patients with cytomegalovirus-associated thrombosis

BackgroundThrombosis is a rare complication of cytomegalovirus (CMV) infection in immunocompetent patients. The clinical circumstances of this complication have never been studied, to the best of our knowledge.AimWe reviewed all reports on CMV-associated thrombosis in immunocompetent adults found in the literature, in search for thrombosis risk factors other than CMV.MethodsOur search yielded 32 case reports and case series on CMV-associated thrombosis in immunocompetent adults. Reports on immunocompromised patients, infants and elderly patients were excluded. All reports were reviewed for other, acquired as well as inherited, predispositions for thrombosis.ResultsReports on 39 immunocompetent adults were reviewed, mean age for which was 34.9 ± 10.8 years. Overall, 14 (35.9%) patients had one or more acquired predispositions for thrombosis; 16 (45.7%) of the 35 patients that were investigated for inherited thrombophilias had one or more inherited predispositions for thrombosis. Only 12 (34.3%) patients were found to have no acquired or inherited predispositions for thrombosis other than CMV. The most common (n = 13; 33.3%) acquired predisposition for thrombosis was daily use of oral contraceptives. The most common (n = 6; 17.1%) inherited predisposition for thrombosis was factor V Leiden mutation.ConclusionsMost immunocompetent adults with CMV-associated thrombosis have other acquired or inherited predispositions for thrombosis. Hence, addressing these predispositions in patients with CMV-associated thrombosis may be of great clinical importance.