Leflunomide use in a cytomegalovirus infection of a patient with dermatomyositis.
Human cytomegalovirus (CMV) is responsible for significant morbidity and mortality in immunocompromised populations, such as those suffering from dermatomyositis (DM). We present here a case study of a DM patient undergoing methotrexate treatment who presents with weakness, myalgia, elevated levels of hepatic transaminases and serological markers of CMV primo-infection. The antiviral activity of leflunomide against CMV was described recently. The use of leflunomide as an immunomodulator may have contributed to the satisfactory evolution of the treatment for a symptomatic CMV infection in an immunocompromised patient, since the typical treatment outcome is more prolonged and with additional complications.
Departments of Internal Medicine, Clínica San Camilo, Alfredo Bufano 2423, 1416 Buenos Aires, Argentina. aoorden@yahoo.com.ar
Alberto O
AO
Orden
Juan C
JC
Chuluyan
Ana C
AC
Colombini
Rubén F
RF
Barbera
D018501:Antirheumatic Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000209:etiology; D003882:Dermatomyositis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007555:Isoxazoles / Q000627:therapeutic use*; D000077339:Leflunomide; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009894:Opportunistic Infections / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D007555:Isoxazoles; D000077339:Leflunomide; D008727:Methotrexate
Curr Opin Organ Transplant. 2009 Aug;14(4):370-4
19512928
Am J Transplant. 2006 Jan;6(1):69-75
16433758
Intervirology. 1999;42(5-6):412-8
10702725
Recent Pat Antiinfect Drug Discov. 2007 Jan;2(1):53-72
18221163
Transplantation. 2004 May 15;77(9):1460-1
15167608
Transplant Proc. 2005 Dec;37(10):4303-5
16387103
Ann Rheum Dis. 2008 May;67(5):723
18408111
Curr Opin Infect Dis. 2008 Aug;21(4):433-7
18594298
Antiviral Res. 2005 Jan;65(1):1-12
15652966
Pediatr Transplant. 2010 Feb;14(1):145-50
19344337
Acta Derm Venereol. 2006;86(6):535-7
17106602
Transpl Infect Dis. 2007 Mar;9(1):28-32
17313468
Transplant Proc. 2009 Jul-Aug;41(6):2533-8
19715969
Rheumatology (Oxford). 2008 Sep;47(9):1373-8
18577548
Klin Padiatr. 2006 May-Jun;218(3):180-4
16688677