Disseminated Varicella Infection in Pediatric Renal Transplant Recipients Treated With Mycophenolate Mofetil

Rothwell, Walter S.; Gloor, James M.; Morgenstern, Bruce Z.; Milliner, Dawn S.

doi:10.1097/00007890-199907150-00030

Cited by 63 publications

(43 citation statements)

References 9 publications

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“…Steroids, antiproliferative agents (azathioprine and mycophenolate), calcineurin inhibitors (cyclosporine and tacrolimus), and target-of-rapamycin inhibitors (sirolimus and everolimus) would interfere with different aspects of immune reaction [15]. It has been suggested that enhanced immunosuppression with mycophenolate mofetil might be a potential risk factor for herpes zoster in RT recipients [16,17]. However, Pandya et al [18 ]found no significant association existing between VZV infection and specific immune suppressants.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Herpes Zoster Incidence across the Spectrum of Chronic Kidney Disease, Dialysis and Transplantation

Lin

Liu

Lin³

et al. 2012

Am J Nephrol

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Background: The effect of different renal replacement therapies on the risk of developing herpes zoster in renal failure patients is unknown. We aimed to investigate the incidence of herpes zoster attack among renal failure patients who were receiving different dialysis modalities, renal transplantation (RT), or not receiving any of the above mentioned therapies yet. Methods: A retrospective cohort study of the national health insurance register database was conducted. This observational cohort study involved 79,581 study controls, 15,802 chronic kidney disease patients, 3,694 hemodialysis (HD) patients, 317 peritoneal dialysis (PD) patients, and 159 RT patients. Results: The RT group had the worst risk of herpes zoster (hazard ratio, HR, 8.46; 95% CI 5.85–12.2), followed by PD (HR 3.61; 95% CI 2.49–4.83) and HD (HR 1.35; 95% CI 1.18–1.55), compared with the comparison group (p < 0.0001). The RT group had also the highest risk of developing herpes zoster with complications among all groups (adjusted HR 15.3). The HRs of the PD group were higher than the HRs of the HD group in terms of herpes zoster or its complications (p < 0.0001 and p = 0.0002, respectively). Conclusions: This study suggests that different treatment modalities are associated with different risks of herpes zoster attacks in renal failure patients. PD patients had higher risks than the HD group in terms of herpes zoster or its complications.

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Section: Discussionmentioning

confidence: 99%

A Comparison of Herpes Zoster Incidence across the Spectrum of Chronic Kidney Disease, Dialysis and Transplantation

Lin

Liu

Lin³

et al. 2012

Am J Nephrol

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“…Some studies suggest that specific agents such as mycophenolate mofetil (MMF) (37,39,49,50) or sirolimus (51) may confer greater risk for herpesvirus reactivation than others. It remains unclear, however, whether this reflects increased risk associated with specific agents or simply reflects greater immunosuppressive potency of these drugs in the combinations and doses used.…”

Section: Effect Of Intensity Of Immunosuppression and Newer Regimensmentioning

confidence: 99%

Herpes Simplex and Varicella Zoster Viruses: Forgotten but Not Gone

Miller

Dummer

2007

American Journal of Transplantation

102

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Herpesvirus infections are common complications of organ transplantation. The most frequent herpesvirus infections are caused by cytomegalovirus (CMV), herpes simplex (HSV) and varicella zoster (VZV). Despite expansion of the therapeutic armamentarium, HSV and VZV continue to cause morbidity and occasional mortality in transplant recipients. Here we review the incidence and risk factors for HSV and VZV disease, their clinical presentation, effects of newer immunosuppressive regimens and prophylaxis for HSV and VZV in solid organ transplant recipients.

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“…Atypical recurrent varicella with disseminated lesions and without dermatomal clustering was described in immunocompromised patients with haemopathies and in paediatric renal transplant recipients treated with mycophenolate mofetil [9,10] . As compared to classical chickenpox and relapsing varicella in children and young adults, disease manifestations were milder with fewer lesions (that all exhibited the same stage of development) [9] .…”

mentioning

confidence: 99%

Recurrent Varicella in an Adult Psoriasis Patient Treated with Etanercept

Bécart¹,

Segaert²

2008

Dermatology

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Disseminated Varicella Infection in Pediatric Renal Transplant Recipients Treated With Mycophenolate Mofetil

Abstract: The enhanced immunosuppression achieved with MMF appears to be associated with increased susceptibility to varicella infection.

Cited by 63 publications

References 9 publications

A Comparison of Herpes Zoster Incidence across the Spectrum of Chronic Kidney Disease, Dialysis and Transplantation

A Comparison of Herpes Zoster Incidence across the Spectrum of Chronic Kidney Disease, Dialysis and Transplantation

Herpes Simplex and Varicella Zoster Viruses: Forgotten but Not Gone

Recurrent Varicella in an Adult Psoriasis Patient Treated with Etanercept

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