title: Successful use of oral ganciclovir for the treatment of intrauterine cytomegalovirus infection in a renal allograft recipient.
abstract: Congenital cytomegalovirus (CMV) infection occurs in approximately 1% of newborns and is the leading infectious cause of congenital birth defects. Female renal allograft recipients who develop CMV infection during pregnancy are at risk for both graft dysfunction and fetal morbidity. DNA-based analysis of amniotic fluid (AF) from at-risk pregnancies has been suggested as an adjunct/substitute for traditional culture. We have shown that CMV-polymerase chain reaction of AF is a useful diagnostic test for congenital CMV infection. Using this test we diagnosed CMV infection in the fetus of a 30-year-old renal transplant recipient. As termination was not an option for the family, the patient was extensively counseled and treated with oral ganciclovir. This resulted in clearance of the virus from the AF and the delivery of a healthy newborn girl, free of CMV disease. This is the first reported case to our knowledge of successful use of maternal ganciclovir to treat intrauterine CMV infection in a pregnant renal transplant recipient.
authors.affiliation: Center for Kidney Diseases and Transplantation, Cedars Sinai Medical Center, UCLA School of Medicine, Los Angeles, CA 90048, USA. dechu.pullyanda@cshs.org
authors.forename: D P
authors.initials: DP
authors.lastname: Puliyanda
authors.forename: N S
authors.initials: NS
authors.lastname: Silverman
authors.forename: D
authors.initials: D
authors.lastname: Lehman
authors.forename: A
authors.initials: A
authors.lastname: Vo
authors.forename: S
authors.initials: S
authors.lastname: Bunnapradist
authors.forename: R K
authors.initials: RK
authors.lastname: Radha
authors.forename: M
authors.initials: M
authors.lastname: Toyoda
authors.forename: S C
authors.initials: SC
authors.lastname: Jordan
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003586:Cytomegalovirus Infections / Q000151:congenital / Q000188:drug therapy* / Q000821:virology; D005260:Female; D005315:Fetal Diseases / Q000188:drug therapy* / Q000821:virology; D015774:Ganciclovir / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology; D011256:Pregnancy Outcome; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir