title: Development of CMV retinitis in an antigenemia-negative infant after cord blood transplantation.
abstract: A five-month-old male infant with familial hemophagocytic lymphohistiocytosis underwent cord blood transplantation using reduced-intensity conditioning. Methylprednisolone (mPSL) pulse administration was performed for marked pulmonary edema during the early phase of transplantation, followed by GVHD treatment with mPSL until day 100. CMV antigenemia was detected on days 27 and 55, but serum became negative with 2- to 3-week ganciclovir (GCV) treatment on both occasions. On day 120, ophthalmological findings included multiple bilateral white spots and a positive PCR study using anterior chamber fluid confirmed the diagnosis of CMV retinitis affecting both eyes, although CMV antigenemia was negative. Re-treatment with GCV had a minimal effect on the ophthalmological findings, while foscarnet administration markedly improved the retinitis and decreased the CMV-DNA level. Considering that a substantial proportion of patients develop CMV retinitis even when CMV antigenemia is not present, routine monitoring involving ophthalmological examinations should be conducted for hematopoietic transplant patients, especially infants, who cannot complain of ocular symptoms.
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Kyoto University.
authors.forename: Akane
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Katsutsugu
authors.initials: K
authors.lastname: Umeda
authors.forename: Koji
authors.initials: K
authors.lastname: Kawaguchi
authors.forename: Koji
authors.initials: K
authors.lastname: Kawada
authors.forename: Sayaka
authors.initials: S
authors.lastname: Maeda
authors.forename: Takako
authors.initials: T
authors.lastname: Kinehara
authors.forename: Satoshi
authors.initials: S
authors.lastname: Saida
authors.forename: Itaru
authors.initials: I
authors.lastname: Kato
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Hiramatsu
authors.forename: Ken-Ichiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yasumi
authors.forename: Toshio
authors.initials: T
authors.lastname: Heike
authors.forename: Akitaka
authors.initials: A
authors.lastname: Tsujikawa
authors.forename: Akito
authors.initials: A
authors.lastname: Uji
authors.forename: Ikuya
authors.initials: I
authors.lastname: Usami
authors.forename: Kiminari
authors.initials: K
authors.lastname: Ito
authors.forename: Souichi
authors.initials: S
authors.lastname: Adachi
mesh_terms: D003586:Cytomegalovirus Infections / Q000188:drug therapy*; D004338:Drug Combinations; D005312:Fetal Blood / Q000637:transplantation; D006801:Humans; D007223:Infant; D008297:Male; D012173:Retinitis / Q000188:drug therapy*
chemical_list: D004338:Drug Combinations