Isolated unilateral cytomegalovirus retinitis: a rare long-term complication after pediatric liver transplantation.
To highlight the rare yet devastating complication of CMV retinitis in a minimally immunosuppressed patient eight yr after liver transplantation for biliary atresia. A 22-yr-old female status-post deceased donor liver transplant at age 13 secondary to biliary atresia receiving single agent immunosuppression presented with acute, unilateral, profound decrease in visual acuity. The patient was diagnosed to have acute onset unilateral CMV retinitis. Retinal examination uncovered classical appearance of retinal whitening and retinal hemorrhages with extensive macular involvement. CMV retinitis can occur as a late complication following liver transplantation. Additionally, CMV retinal disease can occur in the absence of laboratory evidence of CMV infection and independent of additional clinical features suggesting CMV disease. Currently, there is no standard of care regarding screening for CMV retinitis, and thus, further research is needed to define the need for potential changes in current clinical practices and post-transplant screening protocols.
Pediatric Liver Care Center, Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
James E
JE
Squires
Robert A
RA
Sisk
William F
WF
Balistreri
Rohit
R
Kohli
D001656:Biliary Atresia / Q000150:complications / Q000601:surgery*; D003587:Cytomegalovirus / Q000302:isolation & purification; D017726:Cytomegalovirus Retinitis / Q000150:complications / Q000175:diagnosis*; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017093:Liver Failure / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D013997:Time Factors; D014785:Vision, Ocular; D055815:Young Adult
D007166:Immunosuppressive Agents; D015774:Ganciclovir