title: Successful low-dose leflunomide treatment for ganciclovir-resistant cytomegalovirus infection with high-level antigenemia in a kidney transplant: A case report and literature review.
abstract: Ganciclovir-resistant cytomegalovirus infection is sometimes life-threatening for organ transplant recipients. Foscarnet is an alternative, although it may potentially worsen the preexistent impaired renal function. Here we report the case of a successful low-dose leflunomide treatment in a kidney transplant recipient with very high viral replication, who underwent kidney transplantation 10 years before. Administering 10mg leflunomide daily for 5 months without a loading dose completely cleared the ganciclovir-resistant cytomegalovirus strains.
authors: Department of Urology, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors: Shinya
authors: S
authors: Morita
authors: Department of Urology, Keio University School of Medicine, Tokyo 160-8582, Japan. Electronic address: kshino49@yahoo.co.jp.
authors: Kazunobu
authors: K
authors: Shinoda
authors: Department of Urology, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors: Satoshi
authors: S
authors: Tamaki
authors: Department of Urology, Tokyo Dental College Ichikawa General Hospital, Chiba 272-8513, Japan.
authors: Hidaka
authors: H
authors: Kono
authors: Department of Urology, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors: Hiroshi
authors: H
authors: Asanuma
authors: Department of Urology, Tokyo Dental College Ichikawa General Hospital, Chiba 272-8513, Japan.
authors: Ken
authors: K
authors: Nakagawa
authors: Department of Urology, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors: Mototsugu
authors: M
authors: Oya
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage* / Q000494:pharmacology*; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000821:virology; D024882:Drug Resistance, Viral; D005260:Female; D015774:Ganciclovir / Q000494:pharmacology*; D006801:Humans; D007555:Isoxazoles / Q000008:administration & dosage*; D016030:Kidney Transplantation; D000077339:Leflunomide; D008875:Middle Aged; D066027:Transplant Recipients; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D007555:Isoxazoles; D000077339:Leflunomide; D015774:Ganciclovir
keywords: Cytomegalovirus; Ganciclovir-resistance; Impaired renal function; Kidney transplantation; Leflunomide