Unusual presentation of herpes virus infections in renal transplant recipients exposed to high mycophenolic acid plasma concentrations

Gregoor, P. J. H. Smak; Gelder, Teun van; Overbeeke, I. C. van Riemsdijk-van; Vossen, Ann C.T.M.; IJzermans, Jan N.M.; Weimar, Willem

doi:10.1034/j.1399-3062.2003.00012.x

Cited by 11 publications

(9 citation statements)

References 31 publications

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“…1 Since infection may be allograft or life threatening it is managed with a high index of suspicion and an arsenal of prophylaxis, pre-emptive and therapeutic treatment. 2 A number of the infections characteristic of immunosuppression have typical ocular manifestations.…”

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confidence: 99%

Ocular complications in heart, lung and heart-lung recipients

Akerele¹,

Lightman²

2006

British Journal of Ophthalmology

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Aim: To prospectively assess ocular morbidity and the need for ocular screening in patients on long term, high dose immunosuppression for the maintenance of solid organ transplants. Methods: Dilated ocular examinations were performed on patients receiving immunosuppression for the maintenance of heart, lung and heart-lung transplants. Patients were examined repeatedly in the post transplant period. Results: Of the 115 transplant recipients examined 62 (54%) had ocular findings. The most common findings were cataracts (17% of those examined) followed by hypertensive change (8%), chorioretinal scarring (5%) and diabetic retinopathy (3%). One patient developed ocular infective complications following surgery due to Aspergillus spp. endophthalmitis. 18 patients (16%) were symptomatic at examination with the most common symptom being blurred vision. The most common finding in symptomatic patients was cataract with almost a quarter of patients having posterior subcapsular lens opacity that could be attributed to steroid therapy. Conclusion: Patients had surprising low incidences of ocular infective complications despite previous reports. It is likely that this is due to improved immunosuppression regimes and improved monitoring of immunosuppression in the early posttransplant period. The screening of asymptomatic individuals following heart, lung or heart-lung transplantation was not supported by this study.

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confidence: 99%

Ocular complications in heart, lung and heart-lung recipients

Akerele¹,

Lightman²

2006

British Journal of Ophthalmology

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“…One of the components of this immunosuppressive scheme is MMF, which specifically inhibits B‐lymphocyte and T‐lymphocyte proliferation (12). Reports suggest an increased incidence in severe and unusual manifestations of herpesvirus infections since introduction of MMF (13–15). It has been suggested that high mycophenolic acid (MPA) trough levels are associated with viral infections (15).…”

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confidence: 99%

Unusual presentation of central nervous system manifestations of Varicella zoster virus vasculopathy in renal transplant recipients

Hovens

Vaessen

Sijpkens

et al. 2007

Transplant Infectious Dis

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We describe 2 renal transplant recipients with severe but reversible neurological manifestations related to Varicella zoster virus (VZV) cerebral vasculopathy. To the best of our knowledge, this is the first description of cerebral VZV vasculopathy in solid organ transplant recipients. We review the published literature on the clinical presentation, diagnosis and treatment. In solid organ transplant recipients presenting with neurological signs and symptoms, a diagnosis of VZV-associated vasculopathy should be considered.

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“…levels are associated with an increased frequency of rejection (20), whereas elevated MPA trough levels are related to an increased risk for infections (21). Nevertheless, relevant correlations between MPA trough levels and MPA-AUC values could not be detected, therefore the usefulness of measuring trough levels in routine care of renal transplant recipients is doubted (22)(23)(24).…”

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confidence: 99%