Pp65 antigenemia and cytomegalovirus diagnosis in patients with lupus nephritis: report of a series.

Lino, Katia; Trizzotti, Natalia; Carvalho, Fabiana Rabe; Cosendey, Rachel Ingrid Juliboni; Souza, Cintia Fernandes; Klumb, Evandro Mendes; Silva, Andréa Alice; Almeida, Jorge Reis

doi:10.1590/2175-8239-jbn-3838

Cited by 11 publications

(6 citation statements)

References 38 publications

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“…In our study, CMV viral load at admission was not significantly correlated with final outcomes. CMV reactivation and risk for CMV disease possibly related with a subjacent immunosuppressive status may occur as in systemic lupus erythematous or in organ transplant 14 , 15 ; however, characteristics of latency and reactivation of the herpes family should be better monitored in the critically ill COVID-19 patients. For example, many of the reported cases and series of CMV-associated to cytokine storm syndromes involve viral reactivation during immune suppressed states.…”

Section: Discussionmentioning

confidence: 99%

Serum ferritin at admission in hospitalized COVID-19 patients as a predictor of mortality

Lino¹,

Guimarães²,

Alves³

et al. 2021

The Brazilian Journal of Infectious Diseases

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Section: Discussionmentioning

confidence: 99%

Serum ferritin at admission in hospitalized COVID-19 patients as a predictor of mortality

Lino¹,

Guimarães²,

Alves³

et al. 2021

The Brazilian Journal of Infectious Diseases

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“…CMV infection is known to be highly prevalent in SLE patients but is often only diagnosed after the appearance of unfavorable outcomes. This may be due to the unavailability of diagnostic methods and/or similarities between the clinical manifestations of CMV infection and SLE during flares [2,5].…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus pericarditis as a triggering factor for macrophage activation syndrome in a patient with systemic lupus erythematosus: Case report and review of the literature

Cruz

2024

Open J Clin Med Case Rep

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Macrophage Activation Syndrome (MAS) is a form of lymphohistiocytosis occurring in autoimmune diseases. Viral infections, including Cytomegalovirus (CMV), are major triggers of MAS and require specific treatment. We report a rare case of a 25-year old woman with persistent fever and clinical and lab findings Suggestive of Lupus (SLE). The patient experienced MAS and pericarditis refractory to immunosuppression and was later diagnosed with active CMV infection, identified as a trigger factor. Treatment with ganciclovir and maintenance of immunosuppression led to complete and sustained recovery. Only five other patients with SLE associated with MAS and CMV have been reported in the literature, with information on clinical findings, diagnostic methods and outcomes. The mean age of the reviewed cases was 22-58 years, the female sex was predominant, but only half the cases had a previous diagnosis of SLE. All patients improved with ganciclovir and only one death occurred due to hemorrhagic complications from colon ulcer. These outcomes highlight the importance of screening for CMV in this patient population.

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“…Although we initiated treatment with ganciclovir and could see an improvement in the C7-HRP test results, the patient’s colitis symptoms did not improve. The specificity of positive CMV antigenemia for diagnosing CMV colitis is high, and the progressive reduction of antigen titers is associated with therapeutic effects[ 11 , 12 ]. In our case, we should have considered amebic colitis because of the discrepancy between the successful lowering of the CMV antigen titers and the unabated colitis symptoms.…”

Section: Discussionmentioning

confidence: 99%

Fulminant amebic colitis in a patient with concomitant cytomegalovirus infection after systemic steroid therapy: A case report

Shijubou¹,

Sumi²,

Kamada³

et al. 2021

WJCC

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BACKGROUND Amebic colitis is an infection caused by Entamoeba histolytica and most commonly observed in regions with poor sanitation. It is also seen as a sexually transmitted disease in developed countries. While amebic colitis usually has a chronic course with repeated exacerbations and remissions, it may also manifest as a fulminant form that rapidly progresses and leads to severe, life-threatening complications, such as intestinal perforation, peritonitis, and sepsis, that have a high mortality rate. CASE SUMMARY A 68-year-old man was admitted to our hospital with chest pain and acute dyspnea. He was diagnosed with acute coronary syndrome, acute heart failure, and bacterial pneumonia. His respiratory condition worsened despite receiving intensive care and intravenous antibiotics. On the fifth day of hospitalization, he was diagnosed with acute respiratory distress syndrome and was started on steroid therapy. He subsequently developed bloody stools and was diagnosed with cytomegalovirus (CMV) enterocolitis based on biopsy results and a peripheral blood CMV pp65 antigenemia test result. Although we started antiviral therapy with ganciclovir, which was successful in reducing his antigen titers, he continued to have bloody diarrhea. Three weeks after initiation of ganciclovir therapy and six weeks after his admission, the patient died from intestinal perforation. We only posthumously diagnosed him with amebic colitis and CMV enterocolitis based on autopsy findings of transmural necrosis of the entire colon with massive ameba infiltration. CONCLUSION We urge clinicians to consider Entamoeba histolytica infection if severe colitis progresses after steroid therapy. Preemptive treatment is recommended then.

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Pp65 antigenemia and cytomegalovirus diagnosis in patients with lupus nephritis: report of a series.

Abstract: Pp65 antigenemia might be relevant in SLE patients, and studies with a greater number of patients are needed in order to establish sensitivity and specificity of pp65 antigenemia in different clinical contexts of SLE patients.

Cited by 11 publications

References 38 publications

Serum ferritin at admission in hospitalized COVID-19 patients as a predictor of mortality

Serum ferritin at admission in hospitalized COVID-19 patients as a predictor of mortality

Cytomegalovirus pericarditis as a triggering factor for macrophage activation syndrome in a patient with systemic lupus erythematosus: Case report and review of the literature

Fulminant amebic colitis in a patient with concomitant cytomegalovirus infection after systemic steroid therapy: A case report

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