title: Successful treatment of renal allograft rejection in the presence of cytomegalovirus disease. A report of two cases.
abstract: We report 2 patients who developed cytomegalovirus (CMV) infection following renal transplantation. Both patients were treated with 9-(1,3-dihydroxy-2-propoxymethyl) guanine (ganciclovir). In the presence of CMV disease, both patients also had progressive elevations of the serum creatinine, which were attributed to graft rejection. Antirejection therapy was administered, with OKT3 in one case and pulse methylprednisolone in the other. Renal function improved in both patients, and CMV disease abated. These cases unique because antirejection therapy was instituted in the presence of documented CMV disease, without adverse sequelae. We believe that the administration of ganciclovir lessened the severity of CMV infection, while allowing the rejection episodes to be aggressively treated.
authors.affiliation: Department of Medicine, Ottawa General Hospital, University of Ottawa School of Medicine, Ont., Canada.
authors.forename: K D
authors.initials: KD
authors.lastname: Burns
authors.forename: L
authors.initials: L
authors.lastname: Johnson-Whittaker
authors.forename: R A
authors.initials: RA
authors.lastname: Couture
authors.forename: L
authors.initials: L
authors.lastname: Eidus
authors.forename: G
authors.initials: G
authors.lastname: Garber
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000209:etiology; D015774:Ganciclovir / Q000627:therapeutic use; D006084:Graft Rejection; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000473:pathology / Q000503:physiopathology; D016030:Kidney Transplantation; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011183:Postoperative Complications
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D015774:Ganciclovir; D008775:Methylprednisolone