Unusual presentation of herpes virus infections in renal transplant recipients exposed to high mycophenolic acid plasma concentrations.
Viral infections constitute an important problem for transplant recipients and their physicians. Often the balance between adequate and over-immunosuppression is hard to find and therapeutic drug monitoring might be a welcome adjunct in the management of transplant patients. We report four renal transplant recipients with extra-ordinary presentations of viral disease who were all treated with mycophenolate mofetil and in whom high mycophenolic acid (MPA) trough levels were found. High MPA levels may reflect over-immunosuppression resulting in infectious complications.
Smak Gregoor
P J H
PJ
Department of Internal Medicine, Room D-412, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands. smakgregoor@inw1.azr.nl
van Gelder
T
T
van Riemsdijk-van Overbeeke
I C
IC
Vossen
A C T M
AC
IJzermans
J N M
JN
Weimar
W
W
D000328:Adult; D003587:Cytomegalovirus / Q000302:isolation & purification; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy*; D006564:Herpesviridae / Q000302:isolation & purification; D006566:Herpesviridae Infections / Q000503:physiopathology / Q000821:virology*; D014645:Herpesvirus 3, Human / Q000302:isolation & purification; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D015166:Monitoring, Immunologic; D009173:Mycophenolic Acid / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000493:pharmacokinetics*; D018139:Simplexvirus / Q000302:isolation & purification
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid