Very late‐onset cytomegalovirus disease with ganciclovir resistance &gt;15 years following renal transplantation

Khan, Sadid F; Yong, Michelle K.; Slavin, Monica A; Hughes, Peter; Sasadeusz, Joseph

doi:10.1111/tid.13441

Cited by 5 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other factors such as immunosenescence associated with chronic kidney disease, postulated to be important in very late CMV disease, may have contributed. [13][14][15] In CDI, Clostridium difficile toxin disrupts cell signaling pathways, causing cell death and disruption of epithelial tight junctions, allowing the influx of neutrophils into the mucosa and formation of pseudomembranes. 16,17 The mechanism of pseudomembrane formation in CMV colitis may be similar to that in ischemic colitis.…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus‐associated pseudomembranous colitis in a kidney transplant recipient

Chua

Ngo

et al. 2021

Transplant Infectious Dis

View full text Add to dashboard Cite

Pseudomembranous colitis (PMC) is classically associated with Clostridium difficile infection. We report a rare case of cytomegalovirus (CMV)-associated PMC in a 52year-old female patient who had undergone kidney transplantation more than 20 years ago and was on low dose prednisolone and ciclosporin. She presented with an acute history of fever, lethargy, vomiting and diarrhoea on admission. Computed tomography of the abdomen showed extensive colitis, and colonoscopy revealed extensive pseudomembrane formation. Multiple tests for Clostridium difficile and other common microbiological causes of colitis were negative. CMV DNAemia and colonic biopsies confirmed the diagnosis of CMV colitis. The patient responded to prompt CMV treatment, as demonstrated by clinical, endoscopic, and histological response. While CMV is a common pathogen in the solid organ transplant population that is familiar to most transplant physicians, it may present atypically as PMC. Here, we review the literature on CMV-associated PMC and its relevance to solid organ transplant recipients. To our knowledge, this is the first reported case of CMV-associated PMC in a kidney transplant recipient.

show abstract

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus‐associated pseudomembranous colitis in a kidney transplant recipient

Chua

Ngo

et al. 2021

Transplant Infectious Dis

View full text Add to dashboard Cite

show abstract

“…Сравнительный анализ одногодичной выживаемости без нежелательных событий (летальность, отторжение, возврат на гемодиализ) у реципиентов почки в зависимости от стратегии профилактики ЦМВ-инфекции не показал статистических различий (р = 0,537). угольными камнями профилактики ЦМВ-инфекции, однако их недостаточно для предотвращения репликации вируса [11]. За последние два десятилетия стало ясно, что как врожденный, так и специфический иммунитет имеют большое значение в контроле ЦМВ, что потребовало оптимизации протоколов иммуносупрессивной терапии.…”

Section: оценка нежелательных иммунологических событийunclassified

Evaluation of the effectiveness of prophylactic strategies for cytomegalovirus infection in pediatric kidney recipients

Цирульникова

Gadzhieva

Милосердов

et al. 2021

RJTAO

View full text Add to dashboard Cite

Cytomegalovirus (CMV) infection is the most severe viral infection in renal transplant recipients, which can occur in the post-transplant period in both adult and pediatric recipients. Developing and applying an effective prevention and treatment strategy for pediatric renal graft recipients is a priority. Objective: to compare the effectiveness of the protocols used for the prevention of CMV infection in pediatric kidney transplant recipients.Materials and methods. The study enrolled 118 patients who underwent primary kidney transplantation at Shumakov National Medical Research Center of Transplantology and Artificial Organs. Based on retrospective analysis, all recipients were divided into two groups, depending on the prophylactic strategy after kidney transplantation. The followup period for pediatric kidney recipients ranged from 108 to 1803 (623.5 ± 379.5) days. CMV infection activity was monitored by polymerase chain reaction.Results. The frequency of CMV infection activation episodes at 3 and 6 months was independent of the prophylaxis strategy used. The recurrence rate of CMV infection one year after surgery was significantly lower (p = 0.037) with Strategy 2. No cases of CMV syndrome or CMV disease, graft dysfunction, or chronic rejection associated with CMV infection were reported. Increasing the dose of antiviral drugs in Strategy 1 did not increase the risk of cytotoxicity and nephrotoxicity, which are reversible (creatinine levels were not significantly different in the study groups at 3, 6, 12 months, p = 0.542, p = 0.287, p = 0.535, respectively). The incidence of kidney graft rejection did not increase in patients with lower doses of immunosuppressants in Strategy 2.Conclusion. Both prophylactic strategies are effective in pediatric kidney recipients. However, the choice of a strategy depends on the individual characteristics of the patient and requires a personalized approach.

show abstract

“…CMV infection is defined as the presence of CMV replication in tissue, blood, or other bodily fluids regardless of symptomatology, while CMV disease requires CMV infection that is accompanied by clinical signs and symptoms 2 . When CMV disease happens after completion of antiviral prophylaxis it is denominated delayed-onset CMV disease, and when it occurs more than 12 months after transplantation, it is classified as late onset 3 .…”

Section: Introductionmentioning

confidence: 99%

Presumed cytomegalovirus retinitis late after kidney transplant

et al. 2022

View full text Add to dashboard Cite

Cytomegalovirus (CMV) retinitis is a rare manifestation of CMV invasive disease and potentially threatening to vision in immunocompromised individuals. Clinical suspicion is fundamental since it is an unusual entity with a progressive and often asymptomatic installation over a long period. The authors report a 70-year-old man with diabetic nephropathy who underwent a kidney transplant (KT) in August 2014 with good clinical evolution. No previous CMV infection or episodes of acute rejection were reported. Five years after transplant, he was admitted due to a reduced visual acuity of the left eye with seven days of evolution with associated hyperemia, without exudate. The ophthalmologic evaluation was compatible with acute necrosis of the retina and presumed associated with CMV infection. He had a progressive improvement after ganciclovir initiation. CMV retinitis is one of the most serious ocular complications in immune-suppressed individuals and can lead to irreversible blindness, and because of that, early diagnosis and treatment remains crucial in obtaining the best visual prognosis in affected patients. Secondary prophylaxis with ganciclovir is not consensual, neither is the safety of reintroducing the antimetabolite in these cases.

show abstract

Very late‐onset cytomegalovirus disease with ganciclovir resistance >15 years following renal transplantation

Cited by 5 publications

References 19 publications

Cytomegalovirus‐associated pseudomembranous colitis in a kidney transplant recipient

Cytomegalovirus‐associated pseudomembranous colitis in a kidney transplant recipient

Evaluation of the effectiveness of prophylactic strategies for cytomegalovirus infection in pediatric kidney recipients

Presumed cytomegalovirus retinitis late after kidney transplant

Contact Info

Product

Resources

About