Leflunomide: a treatment option for ganciclovir-resistant cytomegalovirus infection after renal transplantation
نویسندگان
چکیده
Cytomegalovirus (CMV) infection after renal transplantation is a problem of increasing concern resulting in significant morbidity and mortality. Widespread use of ganciclovir (GCV) and valganciclovir (VGCV) may cause an increase of CMV resistance to these first line drugs. Other treatment options are sparse and often complicated by adverse events, namely nephrotoxicity associated with foscarnet and cidofovir. Leflunomide may be another treatment option for CMV infections. So far it is not clear if leflunomide can also be used in the case of GCV-resistant CMV infections. Here we describe the use of leflunomide in two patients after renal transplantation with GCV-resistant CMV infections.
منابع مشابه
Use of Leflunomide in Renal Transplant Recipients with Ganciclovir-Resistant/Refractory Cytomegalovirus Infection: A Case Series from the University of Chicago
INTRODUCTION Although antiviral prophylaxis for cytomegalovirus (CMV) is widely used, CMV infection remains common in renal transplant recipients with adverse consequences. METHODS We report 5 cases of renal transplant recipients with resistant CMV infection who were successfully managed with leflunomide at the University of Chicago Medical Center. RESULTS Five renal transplant recipients (...
متن کاملAntiviral agents for preventing cytomegalovirus infection in pediatric renal transplant recipients: A systematic review
Background and Objective: Cytomegalovirus (CMV) infections are associated with severe morbidity and mortality in patients, especially pediatric renal transplantation patients. The use of immunosuppressive agents places these patients at the risk of viral infections. As cytomegalovirus infection influences the graft outcome, adopting useful strategies for limiting this virus after transplantatio...
متن کاملCytomegalovirus Treatment
In treating cytomegalovirus (CMV) infection, it is crucial to decide whether one is treating pre-emptively or if one is treating established disease. Disease may be further divided into viral syndrome and tissue-invasive disease. Generally, mild disease in immunosuppressed patients may be treated with oral valganciclovir. Treatment may also be started with valganciclovir for CMV retinitis in AI...
متن کاملTrip to immunity: resistant cytomegalovirus infection in a lung transplant recipient.
We report the case of a young female lung transplant recipient with difficult-to-treat cytomegalovirus (CMV) disease. While treatment with intravenous (IV) ganciclovir failed due to antiviral drug resistance, a trial with foscarnet resulted in severe side effects. In addition, the patient received IV CMV-specific immune globulins as adjunctive therapy and leflunomide as experimental therapy. In...
متن کاملFast selection of maribavir resistant cytomegalovirus in a bone marrow transplant recipient
BACKGROUND Human cytomegalovirus infections are still significant causes of morbidity and mortality in transplant recipients. The use of antiviral agents is limited by toxicity and evolving resistance in immunocompromised patients with ongoing viral replication during therapy. Here, we present the first documented case of genotypic resistance against maribavir in a bone marrow transplant (BMT) ...
متن کامل