[Relation between cytomegalovirus infection and the so-called intolerance to azathioprine in renal transplantation].
Renal transplant recipients can develop hepatic function abnormalities or severe leucopenia after transplantation. Generally it is thought to be due to azathioprine intolerance and patients are treated by curtailment of immunosuppressive therapy, being subsequently at risk to lose their allograft because of rejection. Evidence of Cytomegalovirus (CMV) infection is also common after renal transplantation. It is generally thought that the majority of these infections are asymptomatic, but they can be accompanied by leucopenia and/or hepatic function abnormalities. Sixty-nine renal transplant recipients have been studied for at least three months in order to investigate the relationship between CMV and azathioprine intolerance after transplantation. Twenty-five out of 58 patients who underwent seroconversion to CMV (a fourfold or greater rise in titer of CMV antibodies) after transplantation or who had a high CMV titer (greater than or equal to 1 : 16) prior to transplant, developed azathioprine intolerance. None of 11 patients who before renal transplantation had low CMV titers and who did'nt underwent seroconversion did not tolerate azathioprine. Therefore the Authors advance the hypothesis that azathioprine intolerance following renal transplantation can be often due to an asymptomatic and unknown CMV infection.
D001379:Azathioprine / Q000009:adverse effects*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000209:etiology* / Q000276:immunology; D004351:Drug Resistance; D006801:Humans; D016030:Kidney Transplantation; D014181:Transplantation Immunology; D014184:Transplantation, Homologous
D001379:Azathioprine
Rapporto tra infezione da virus citomegalico e la cosiddetta intolleranza all'azatioprina nel trapianto renale.