title: Chlorambucil-induced cytomegalovirus infection: a case report.
abstract: BACKGROUND
  Chlorambucil is an alkylating agent used in combination with prednisolone for the treatment of idiopathic membranous nephropathy. Although chlorambucil is generally well-tolerated, it is a myelosuppresive drug that can cause several infections.
  
  
  METHODS
  We report the case of an 81-year-old Caucasian male presenting with idiopathic membranous nephropathy who developed fever, cough, dyspnea, pulmonary infiltrates, and abdominal pain shortly after the initiation of treatment with chlorambucil and corticosteroids for nephropathy. Virology tests for infectious diseases revealed a recent cytomegalovirus infection. Antiviral treatment (ganciclovir) resulted in full remission.
  
  
  CONCLUSIONS
  Cytomegalovirus infection should be considered in the differential diagnosis of respiratory symptoms and pulmonary infiltrates in patients treated with chlorambucil for nephrotic syndrome.
authors.affiliation: Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Calle del Obispo Rafael Torija s/n, 13005 Ciudad Real, España. mtl.lluva@gmail.com.
authors.forename: María Thiscal
authors.initials: MT
authors.lastname: López-Lluva
authors.forename: María Dolores Sanchez
authors.initials: MD
authors.lastname: de la Nieta-García
authors.forename: Jesús
authors.initials: J
authors.lastname: Piqueras-Flores
authors.forename: Minerva
authors.initials: M
authors.lastname: Arambarri-Segura
authors.forename: Alberto
authors.initials: A
authors.lastname: Martínez-Calero
authors.forename: Francisco
authors.initials: F
authors.lastname: Rivera-Hernández
mesh_terms: D000369:Aged, 80 and over; D000477:Alkylating Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002699:Chlorambucil / Q000009:adverse effects* / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000139:chemically induced* / Q000175:diagnosis; D015433:Glomerulonephritis, Membranous / Q000188:drug therapy; D006801:Humans; D008297:Male
chemical_list: D000477:Alkylating Agents; D002699:Chlorambucil