TY  - JOUR
AB  - The management of multidrug-resistant strains of cytomegalovirus after solid organ transplantation is challenging. This case report demonstrates the successful treatment of a multidrug-resistant strain of cytomegalovirus that may represent a valuable option for problematic cases. This report illustrates the emergence of a multidrug-resistant cytomegalovirus (CMV) UL54 mutant strain in a renal transplant recipient with severe lymphopenia and thrombocytopenia. We show that the combined treatment with high-dose intravenous cytomegalovirus-specific immunoglobulins (CMV-IVIG) after the switch to a mammalian target of rapamycin (mTOR)-inhibitor and cyclosporine A was a successful treatment alternative to direct antiviral treatment with high-dose ganciclovir and foscarnet. This treatment was associated with a quantitative induction of CMV-specific CD4 and CD8 T cells that showed maturation in phenotype and functionality with decreasing viral load. Our case report illustrates that high-dose CMV-IVIG and conversion of immunosuppressive drugs to mTOR inhibitors and cyclosporine A can be a successful treatment in a situation where the use of direct antiviral drugs was considered insufficient.
AU  - Wiening, Vanessa
AU  - Schmidt, Tina
AU  - Dahmen, Maximilian
AU  - Siam, Sami
AU  - Reuter, Stefan Johannes
AU  - Pavenstädt, Hermann-Joseph
AU  - Sester, Martina
AU  - Suwelack, Barbara
DA  - 2021-01-25
DO  - 10.17879/83009621826
KW  - multidrug-resistant cytomegalovirus
KW  - high dose immunoglobulins
KW  - renal transplant
KW  - case report
KW  - cytomegalovirus-specific cellular immunity
LA  - eng
N1  - Frontiers in Immunology 11 (2021) 623178, 1-5
N1  - Finanziert durch den Open-Access-Publikationsfonds der Westfälischen Wilhelms-Universität Münster (WWU Münster).
PY  - 2021-01-25
TI  - Case Report: Management of a Multidrug-Resistant CMV-Strain in a Renal Transplant Recipient by High-Dose CMV-Specific Immunoglobulins, Modulation in Immunosuppression, and Induction of CMV-Specific Cellular Immunity
UR  - https://nbn-resolving.org/urn:nbn:de:hbz:6-23009718170
Y2  - 2024-11-22T03:12:20
ER  -