Successful use of oral ganciclovir for the treatment of intrauterine cytomegalovirus infection in a renal allograft recipient

Puliyanda, Dechu; Silverman, Neil S.; Lehman, D.; Vo, Ashley; Bunnapradist, Suphamai; Radha, Raju; Toyoda, Mieko; Jordan, Stanley C.

doi:10.1111/j.1399-3062.2005.00089.x

Cited by 73 publications

(32 citation statements)

References 26 publications

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“…In several case reports, both intravenously and by mouth, valganciclovir has been shown safe and effective for use in mothers with fetuses infected in the early stages of pregnancy without teratogenicity [11]. However, the safety and efficacy of ganciclovir in prenatal therapy should be further evaluated by means of clinical trials.…”

Section: Introductionmentioning

confidence: 99%

Cholestasis in Newborn

Xavier¹

2013

J Med Cases

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Cytomegalovirus (CMV) is one of the most important intrauterine infections that cause birth defects in humans with hematogenous transmission rate of 0.5% to 2.5%, on average. The early transmission of infection from mother to fetus decreases the prognosis and increases the chances of serious anomalies. The objective of this case report is to instruct the neonatologist that despite the rarity of neonatal cholestasis, this may be a case of intrahepatic cholestasis resulting from congenital cytomegalovirus infection. This study aims to report the case of a 28 weeks and 6 days old child, presenting 1080 g birth weight, Apgar score 5 and 8, untreated sepsis, thrombocytopenia, leukocytosis, and jaundice with predominance in the evolution of direct bilirubin. To find out the cause of jaundice, serum bilirubin levels, serology and PCR (polymerase chain reaction) were performed for cytomegalovirus. Serology for cytomegalovirus was negative in spite of the molecular analysis by PCR in urine samples having demonstrated consistent results with the identification of genomic sequences of cytomegalovirus. Bilirubin values were: Total 15.58 mg%; Direct 12.36 mg%. It was concluded that treatment with ganciclovir resulted in satisfactory clinical response to treatment of cholestatic jaundice source cytomegalovirus.

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Section: Introductionmentioning

confidence: 99%

Cholestasis in Newborn

Xavier¹

2013

J Med Cases

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“…Ganciclovir is not licensed in pregnancy, as animal studies have demonstrated teratogenicity, however, a number of published case reports describe the safe use of ganciclovir during pregnancy without adverse fetal outcome 11,12 . Our HIV infected patient had a high CMV viral load (97,129cpm) and was clinically symptomatic, hence the decision to treat for both maternal and fetal benefit.…”

Section: Discussion Referring To Relevant Literaturementioning

confidence: 99%

Symptomatic primary Cytomegalovirus infection in a HIV-positive pregnant woman

et al. 2014

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“…The rate of neonatal disease for treated and untreated fetuses was 52 % vs. 58 % [23]. Another study reported that a pregnant woman with CMV infection had complete clearance of the virus from the amniotic fluid and subsequently had a healthy neonate with the use of prenatal ganciclovir [24]. Prenatal administration of ganciclovir into the umbilical vein also has been reported, but its value in improving the prognosis is not well established.…”

Section: Treatment Of Congenital CMV Infectionmentioning

confidence: 99%

CMV Infection and Pregnancy

Tung

et al. 2012

Curr Obstet Gynecol Rep

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Cytomegalovirus (CMV) occurs in 0.2 % to 2.2 % of all live births and is the most common cause of intrauterine infection and the leading infectious cause of sensorineural hearing loss and mental retardation. This article reviews literature that relate to the pathogenesis, diagnosis, and treatment of this disease for pregnant women and their fetus. Primary maternal CMV infection during pregnancy has a much higher rate of mother-to-fetus transmission and causes symptoms at birth and long-term disability than nonprimary infection. In addition, some research has shown that children with congenital CMV infection following first-trimester maternal infection are more likely to have severe sequelae. The prenatal diagnosis of fetal CMV infection includes serological testing (IgM detection and IgG avidity assay), amniocentesis, and ultrasound examination. The combination of the presence of CMV IgM antibodies and low CMV IgG avidity, along with maternal or fetal symptoms is used for the diagnosis of a primary maternal infection. Amniocentesis should be complemented until approximately 20-21 weeks of gestation to increase the sensitivity. Because ultrasound abnormalities are only found in less than 25 % of infected fetuses, ultrasound is as a relatively poor predictor of symptomatic congenital infection. CMV hyperimmunoglobulin also may be considered when the pregnant women are confirmed as primary CMV infection with low IgG avidity and amniotic fluid is found to contain CMV or CMV DNA. There is no consensus on the benefit of prenatal administration of ganciclovir into the umbilical vein.

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Successful use of oral ganciclovir for the treatment of intrauterine cytomegalovirus infection in a renal allograft recipient

Cited by 73 publications

References 26 publications

Cholestasis in Newborn

Cholestasis in Newborn

Symptomatic primary Cytomegalovirus infection in a HIV-positive pregnant woman

CMV Infection and Pregnancy

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