Clinical significance of cytomegalovirus (CMV) pp65 antigenemia in the prediction of CMV infection during immunosuppressive therapy for rheumatic disease

Suga, Kyôichi; Nishiwaki, Aya; Nakamura, Takayuki; Kagami, Shin-ichiro

doi:10.1007/s00296-022-05196-z

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…Previous studies suggested predictive factors of CMV viremia during the clinical course of AAV. Low levels of total protein, hemoglobin, platelet count, lymphocytopenia, a high dose of glucocorticoid therapy, and oral candida infection may be useful markers for the prediction of CMV viremia during the treatment of AAV [8,[46][47][48]. However, these studies did not extensively discuss any specific predictive markers associated with CMV-AAV or CMV-AAV-TMA.…”

Section: Discussionmentioning

confidence: 99%

Investigation of Clinical Features and Association between Vascular Endothelial Injury Markers and Cytomegalovirus Infection Associated with Thrombotic Microangiopathy in Patients with Anti-Neutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis: Case-Based Research

Nimura,

Aomura,

Harada

et al. 2024

IJMS

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Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) can occasionally trigger thrombotic microangiopathy (TMA). Cytomegalovirus (CMV) may be reactivated during intensive immunosuppressive therapy for AAV and cause TMA. Therefore, we aimed to evaluate the clinical features of and the association between vascular endothelial injury markers and TMA due to CMV in patients with AAV. A 61-year-old female was diagnosed with AAV and severe kidney injury. Immunosuppressive therapy gradually improved her symptoms and laboratory findings. However, 2 weeks after induction therapy initiation, she exhibited altered consciousness, a significant decrease in platelet count, and hemolytic anemia, resulting in a TMA diagnosis. Plasma exchange did not improve TMA findings and routine screening test revealed CMV infection. Ganciclovir injection improved the infection and TMA findings. Consequently, we diagnosed her with CMV-induced TMA. Both AAV and CMV may induce severe vascular endothelial injury, potentially leading to TMA development. CMV-induced TMA should be considered when TMA develops during induction therapy against AAV. Moreover, of the three serum markers of vascular injury—serum sulfatides, soluble thrombomodulin, and pentraxin 3—serum sulfatides may be associated with the development of TMA, and a high level of soluble thrombomodulin may be associated with the development of CMV viremia during the clinical course of AAV.

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Section: Discussionmentioning

confidence: 99%

Investigation of Clinical Features and Association between Vascular Endothelial Injury Markers and Cytomegalovirus Infection Associated with Thrombotic Microangiopathy in Patients with Anti-Neutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis: Case-Based Research

Nimura,

Aomura,

Harada

et al. 2024

IJMS

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“…7,10 Several single-center studies indicated the risk factors of CMV infection and mortality in patients with various rheumatic diseases, including age ≥60, lymphopenia, and pulse therapy. 7,[11][12][13] In the present study, we analyzed the associated factors via a nationwide database, including miscellaneous immunosuppressants, in all AIIRDs.…”

Section: Because Of Their Immune Dysfunction and Lifelong Immuno-mentioning

confidence: 99%

Epidemiology and risk factors for cytomegalovirus disease in autoimmune inflammatory rheumatic diseases: A nationwide population‐based study in Taiwan

Li,

Su,

Lai

et al. 2024

Int J of Rheum Dis

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A review on cytomegalovirus in patients with autoimmune inflammatory rheumatic diseases: Prevalence, clinical spectrum, treatment, and antiviral prophylaxis

Brianna,

Masnammany,

2024

Proceedings of Singapore Healthcare

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Human cytomegalovirus (CMV) is a highly infectious virus that is prevalent among adults worldwide. In immunocompetent individuals, CMV infection rarely causes complications. Following initial infection, however, CMV remains latent in the body and can be reactivated especially in immunocompromised patients, such as those with autoimmune inflammatory rheumatic diseases (AIIRDs), leading to tissue-invasive, life-threatening diseases, such as colitis, vascular thrombosis, and pneumonitis. Although there are standard treatment recommendations for symptomatic CMV disease, there is paucity of consensus in the role of primary and secondary antiviral prophylaxis to prevent CMV reactivation, especially in AIIRDs patients undergoing immunosuppressive therapy. Therein, this review aimed to provide an overview of the prevalence, clinical disease, risk factors, and treatment for CMV infection, as well as on the role of primary and secondary antiviral prophylaxis in AIIRDs patients. The emerging novel techniques that measure CMV-specific T-cell immunity as a guide to initiate prophylaxis in high-risk patients were also discussed.

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Clinical significance of cytomegalovirus (CMV) pp65 antigenemia in the prediction of CMV infection during immunosuppressive therapy for rheumatic disease

Cited by 4 publications

References 28 publications

Investigation of Clinical Features and Association between Vascular Endothelial Injury Markers and Cytomegalovirus Infection Associated with Thrombotic Microangiopathy in Patients with Anti-Neutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis: Case-Based Research

Investigation of Clinical Features and Association between Vascular Endothelial Injury Markers and Cytomegalovirus Infection Associated with Thrombotic Microangiopathy in Patients with Anti-Neutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis: Case-Based Research

Epidemiology and risk factors for cytomegalovirus disease in autoimmune inflammatory rheumatic diseases: A nationwide population‐based study in Taiwan

A review on cytomegalovirus in patients with autoimmune inflammatory rheumatic diseases: Prevalence, clinical spectrum, treatment, and antiviral prophylaxis

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