title: Cytomegalovirus Retinitis in Three Pediatric Cases with Acute Lymphoblastic Leukemia: Case Series and Review of the Literature.
abstract: Cytomegalovirus (CMV) retinitis is typically diagnosed in patient with AIDS and those who underwent allogeneic hematopoietic cell transplant. However, it may develop in patients with acute lymphoblastic leukemia (ALL) who have not undergone hematopoietic cell transplantation. To increase awareness of CMV retinitis in this group, we describe 3 patients ages 3, 9, and 12, with ALL who developed CMV retinitis. The diagnosis of CMV retinitis was made on the basis of ophthalmological findings suggesting typical retinal lesions. In 2 cases, CMV DNAemia was present, while in 1 patient CMV DNA was detected only in vitreous fluid using the PCR technique. All cases were treated with intravenous ganciclovir for 2 or 3 weeks as induction therapy, followed by oral valganciclovir prophylaxis. Initially, active retinitis lesions resolved in all cases; however, in 1 patient CMV retinitis relapsed 3 times during follow-up. In this case, by using foscarnet therapy, satisfactory responses were achieved and the progression of CMV retinitis lesions stopped and eventually regressed.
authors.affiliation: Division of Pediatric Infectious Diseases, Marmara University School of Medicine.
authors.forename: Sevliya Öcal
authors.initials: SÖ
authors.lastname: Demir
authors.forename: Hande
authors.initials: H
authors.lastname: Çeliker
authors.forename: Ayşe
authors.initials: A
authors.lastname: Karaaslan
authors.forename: Eda Kepenekli
authors.initials: EK
authors.lastname: Kadayifci
authors.forename: Gülşen
authors.initials: G
authors.lastname: Akkoç
authors.forename: Serkan
authors.initials: S
authors.lastname: Atıcı
authors.forename: Nurhayat
authors.initials: N
authors.lastname: Yakut
authors.forename: Emel
authors.initials: E
authors.lastname: Şenay
authors.forename: Haluk
authors.initials: H
authors.lastname: Kazokoğlu
authors.forename: Ahmet
authors.initials: A
authors.lastname: Koç
authors.forename: Mustafa
authors.initials: M
authors.lastname: Bakır
authors.forename: Ahmet
authors.initials: A
authors.lastname: Soysal
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D000293:Adolescent; D000998:Antiviral Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D017726:Cytomegalovirus Retinitis / Q000175:diagnosis* / Q000473:pathology*; D004279:DNA, Viral / Q000097:blood; D005123:Eye / Q000473:pathology / Q000821:virology; D017245:Foscarnet / Q000008:administration & dosage; D015774:Ganciclovir / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D000077562:Valganciclovir; D014766:Viremia / Q000175:diagnosis; D014822:Vitreous Body / Q000821:virology
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D017245:Foscarnet; D000077562:Valganciclovir; D015774:Ganciclovir