Cytomegalovirus disease of late onset following renal transplantation: a potentially fatal entity.
CMV disease (CMVD) is a recognized problem of the early post-transplant period (PTP) in renal transplant recipients. Information on CMVD in the late (> or = 2 years) PTP is scarce. We have observed 5 cases of CMVD during late (3-8 years) PTP during the last 15 years. Three of these patients died from CMVD. One of the patients with late-onset CMVD recovered spontaneously from mild pneumonitis, 1 patient with severe CMVD after therapy with ganciclovir/anti-CMV-IgG. CMVD was ascribed to primary infection in 4/5 patients, and transmission was attributed to blood products in 2 cases. At the time of CMVD, 4/5 patients were on stable immunosuppression with azathioprine/prednisone; 1 patient who died had received prednisone pulses 1 month prior to CMVD. Late onset CMVD is an underreported disease in renal transplant recipients, which warrants preventive measures and consideration of antiviral therapy.
Boehler
A
A
Department of Internal Medicine, University Hospital, Zürich, Switzerland.
Schaffner
A
A
Salomon
F
F
Keusch
G
G
D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D003587:Cytomegalovirus / Q000276:immunology / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000209:etiology* / Q000382:microbiology / Q000635:transmission; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D065227:Transfusion Reaction
D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents