Hyperbaric oxygen therapy in BKV-associated hemorrhagic cystitis refractory to intravenous and intravesical cidofovir: case report and review of literature.
Hemorrhagic cystitis is a common complication in hematopoietic stem cell transplant recipients. We report here a case of severe BKV-associated hemorrhagic cystitis who did not respond to intravenous cidofovir. Overt hematuria successfully resolved after a few days on hyperbaric oxygen and intravesical instillations of cidofovir, while BK viruria dropped after a few weeks and remained low. We review the literature for therapeutic options in hemorrhagic cystitis and try to explain how hyperbaric oxygen stimulates mucosal repair in the urinary bladder.
Focosi
Daniele
D
Division of Hematology, Department of Oncology, Transplantations and New Technologies in Medicine, University of Pisa, Italy. dfocosi@tin.it
Maggi
Fabrizio
F
Pistolesi
Donatella
D
Benedetti
Edoardo
E
Papineschi
Federico
F
Galimberti
Sara
S
Ceccherini-Nelli
Luca
L
Petrini
Mario
M
D000283:Administration, Intravesical; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D000998:Antiviral Agents / Q000008:administration & dosage*; D001739:BK Virus; D000077404:Cidofovir; D003556:Cystitis / Q000209:etiology / Q000628:therapy*; D003586:Cytomegalovirus Infections / Q000628:therapy; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018380:Hematopoietic Stem Cell Transplantation; D006417:Hematuria / Q000209:etiology / Q000628:therapy; D006801:Humans; D006931:Hyperbaric Oxygenation; D015470:Leukemia, Myeloid, Acute / Q000628:therapy / Q000821:virology; D008297:Male; D063065:Organophosphonates / Q000008:administration & dosage*; D027601:Polyomavirus Infections / Q000150:complications / Q000628:therapy / Q000652:urine; D014412:Tumor Virus Infections / Q000150:complications / Q000628:therapy / Q000652:urine
D000970:Antineoplastic Agents; D000998:Antiviral Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir