Pancytopenia With Hypercellular Bone Marrow Secondary to Cytomegalovirus After Cardiac Transplant

We describe a case of cytomegalovirus-induced pancytopenia in a heart transplant patient. The interesting finding of a hypercellular bone marrow indicates the possibility of a different mechanism for the pancytopenia other than bone marrow suppression. The patient was treated with ganciclovir, which resulted in the complete resolution of the viremia and pancytopenia. Cytomegalovirus infection should be suspected in heart transplant patients with pancytopenia, regardless of bone marrow results. The pathogenesis of cytomegalovirus-induced pancytopenia is likely multifactorial, with both a central and peripheral effect.