title: Disseminated cytomegalovirus infection complicating active treatment of systemic lupus erythematosus: an emerging problem.
abstract: Patients with systemic lupus erythematosus (SLE) often require immunosuppression to induce remission of active disease exacerbations. Over the past two decades, treatment modalities for this condition have emerged leading to improved morbidity from disease related outcomes. However, as a result, infection risks and patterns have changed, leading to higher rates of opportunistic infections among this population. We report four cases of cytomegalovirus (CMV) in patients with SLE who received immunosuppressive therapy, including pulse steroids, antimetabolites such as mycophenolate mofetil, and alkylating agents such as cyclophosphamide. We propose that given the rise in prevalence of CMV, there is a need for appropriate screening for this opportunistic pathogen and studies to determine the risks and benefits of prophylactic or preemptive treatment for this virus.
authors.affiliation: NYU Medical Center Division of Rheumatology, New York, USA.
authors.forename: N
authors.initials: N
authors.lastname: Berman
authors.affiliation: NYU Medical Center Division of Rheumatology, New York, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Belmont
mesh_terms: D000328:Adult; D000477:Alkylating Agents / Q000627:therapeutic use; D000963:Antimetabolites / Q000009:adverse effects / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000175:diagnosis*; D019468:Disease Management; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects / Q000379:methods; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000276:immunology / Q000821:virology*; D008875:Middle Aged; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000477:Alkylating Agents; D000963:Antimetabolites; D013256:Steroids
keywords: Nephritis; renal lupus; systemic lupus erythematosus