Late Onset of Fatal Cytomegalovirus Infection After Renal Transplantation

Linnemann, Calvin C.

doi:10.1001/archinte.1978.03630330047013

Cited by 34 publications

(4 citation statements)

References 9 publications

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“…However, it is unclear whether CMV infections may simply reflect the degree of immunosuppression (3,6,8,9,11) or if CMV is directly able to increase the risk of PCP (12). Nevertheless, it was noteworthy that CMV has an immunosuppressive effect, and causes a marked impairment of cell-mediated immunity (46), that could reinforce the idea that CMV infection is a causal risk factor for PCP that is independent of the state of immunosuppression (12).…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Pneumocystis Pneumonia in Solid Organ Recipients in the Era of the Common Use of Posttransplantation Prophylaxis

Iriart

Belval²,

Fillaux³

et al. 2015

American Journal of Transplantation

118

170

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Xavier Iriart, iriart.x@chu-toulouse.fr y Both authors contributed equally. Pneumocystis pneumonia (PCP) in solid organ transplant (SOT) recipients becomes rare in the immediate posttransplantation period thanks to generalized prophylaxis. We aimed to identify the predictive factors for PCP in the era of universal prophylaxis and to propose a strategy for preventing PCP beyond the first year after transplantation. In a retrospective case-control study, 33 SOT cases with PCP diagnosed between 2004 and 2010 were matched with two controls each to identify risk factors for PCP by uniand multivariate analysis. All the patients benefited from 6 months of posttransplantation trimethoprimsulfamethoxazole prophylaxis. Most PCP in SOT patients occurred during the second year posttransplantation (33%). By univariate analysis, age, nonuse of tacrolimus, total and CD4 lymphocyte counts, gammaglobulin concentration and cytomegalovirus (CMV) infection appeared to be PCP risk factors. In the final multivariate analysis, age (adjusted odds ratio [OR] 3.7, 95% confidence interval [CI]: 1.3-10.4), CMV infection (OR: 5.2, 95% CI: 1.8-14.7) and total lymphocyte count (OR: 3.9, 95% CI: 1.4-10.7) were found to be independently associated with PCP. The second year posttransplantation appeared to be the new period of highest risk of PCP. Age, CMV viremia and lymphocytes were the most pertinent predictive criteria to evaluate the risk of PCP in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Risk Factors of Pneumocystis Pneumonia in Solid Organ Recipients in the Era of the Common Use of Posttransplantation Prophylaxis

Iriart

Belval²,

Fillaux³

et al. 2015

American Journal of Transplantation

118

170

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“…According to Linnemann et al [7] 14 out of 15 patients developed CMV infection 2 months after transplantation. Fiala et al [4] describes a 2-month period after transplantation for the onset of CMV infection symptoms -closely related to the occurrence of CMV viremia.…”

Section: Discussionmentioning

confidence: 99%

Influence of immunosuppressive therapy with azathioprine and prednisolone on serum-immunoglobuline concentration in renal transplanted patients

et al. 1985

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Serological diagnosis of infectious diseases are based on the assumption that a change in virus-specific antibody - titer reflects the response to a certain viral infection due to changes in the concentration of the respective virus - specific antibodies. On the other hand immunosuppressive medication interacts with that system responsible in producing antigen-specific antibodies. This study was outlined therefore to follow the variation of the concentration of serum immunoglobulins of classes IgG and IgM with regard to a better evaluation of virus-specific antibody titers especially for those viruses that remain persistent after a primary infection and an reactivate. The study followed ten patients after allogenic cadaver kidney transplantation under immunosuppressive medication with azathioprine and corticosteroids. Concentration of serum-IgG and -IgM protein was continuously measured for 6 months after transplantation along with measurement of virus-specific antibody-titers with enzyme immunoassay (Elisa) especially for cytomegalovirus. The results show a drastic decrease in serum immunoglobulins IgG and IgM - the lowest concentration being reached 25-50 days after transplantation. The concentration of IgG increased thereafter if no severe infectious diseases occurred during the post-transplant period. The concentration of IgM seems to react more sensitively upon infectious processes. In general, virus-specific antibody-titers (IgG) follow the sometimes drastic variation in the respective immunoglobulin class. It therefore reveals that antigen-specific antibody-titers in those patients should be controlled continuously during the time after transplantation for better evaluation of titer variations that eventually occur in correlation to the absolute concentration of the immunoglobulin class.

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“…The lymphocyte stimulation (LS) test, an in vitro parameter of CMI, has been pre viously used to demonstrate specific lympho cyte responsiveness to CMV in several groups of patients including transplant recip ients [11] and individuals with acquired im mune deficiency syndrome (AIDS) [12]. The present study examined the response of pe ripheral blood lymphocytes (PBL) to CMV in patients with various grades of cervical dys plasia up to CIS.…”

Section: Introductionmentioning

confidence: 99%

Cell-Mediated Immune Responses to Cytomegalovirus in Patients with Dysplasia of the Uterine Cervix

Neill¹,

Norval²

1985

Gynecol Obstet Invest

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Peripheral blood lymphocytes from 172 women with various degrees of cervical dysplasia were assayed for responsiveness to cytomegalovirus-induced early and late antigens using lymphocyte stimulation tests. No evidence was found to suggest that any group of patients was specifically sensitized to either of the antigens tested. Neither was there any difference between the patient groups in respect of mitogen-induced stimulation. The concept that cytomegalovirus might be involved in cervical cell transformation leading to carcinoma has therefore not been strengthened as a result of this study.

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Late Onset of Fatal Cytomegalovirus Infection After Renal Transplantation

Cited by 34 publications

References 9 publications

Risk Factors of Pneumocystis Pneumonia in Solid Organ Recipients in the Era of the Common Use of Posttransplantation Prophylaxis

Risk Factors of Pneumocystis Pneumonia in Solid Organ Recipients in the Era of the Common Use of Posttransplantation Prophylaxis

Influence of immunosuppressive therapy with azathioprine and prednisolone on serum-immunoglobuline concentration in renal transplanted patients

Cell-Mediated Immune Responses to Cytomegalovirus in Patients with Dysplasia of the Uterine Cervix

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