title: Unusual presentation of herpes virus infections in renal transplant recipients exposed to high mycophenolic acid plasma concentrations.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Room D-412, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands. smakgregoor@inw1.azr.nl
authors.forename: P J H
authors.initials: PJ
authors.lastname: Smak Gregoor
authors.forename: T
authors.initials: T
authors.lastname: van Gelder
authors.forename: I C
authors.initials: IC
authors.lastname: van Riemsdijk-van Overbeeke
authors.forename: A C T M
authors.initials: AC
authors.lastname: Vossen
authors.forename: J N M
authors.initials: JN
authors.lastname: IJzermans
authors.forename: W
authors.initials: W
authors.lastname: Weimar
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid