[Cytomegalovirus infection associated with immunosuppressive therapy in collagen vascular diseases].
OBJECTIVE
We investigated the frequency of cytomegalovirus (CMV) infection during immunosuppressive therapy in collagen vascular disease by using CMV antigenemia assay.


METHODS
CMV antigenemia in fifteen patients with collagen vascular disease were analyzed before and one month after immunosuppressive therapy with more than 30 mg/day of prednisolone.


RESULTS
CMV antigenemia were detected in 9 patients (60%), however no CMV antigenemia detected in all patients before treatment. In 7 of 9 patients CMV infection occurred such as fever, leucocytopenia, thrombocytopenia, liver injury, interstitial pneumonia. In 2 patients of polymyositis/dermatomyositis, creatine phosphokinase (CPK) levels which had decreased once just after treatment started, elevated again although initial dose of prednisolone continued. After ganciclovir administration because of the positive results of CMV antigenemia, elevated CPK levels were normalized immediately.


CONCLUSIONS
Our results showed that CMV infection occurred with high frequency during immunosuppressive therapy, and might mimic the exacerbation of collagen vascular disease. It is important to differentiate CMV infection from increased activity of collagen vascular disease during the treatment.
Yoshihara
S
S
Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka.
Fukuma
N
N
Masago
R
R
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D003095:Collagen Diseases / Q000188:drug therapy*; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D008947:Mixed Connective Tissue Disease / Q000188:drug therapy; D012859:Sjogren's Syndrome / Q000188:drug therapy; D014652:Vascular Diseases / Q000188:drug therapy*
D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D015774:Ganciclovir