TITLE:
A Case of Cytomegalovirus-Induced Arthritis after Lymphocyte-Depleting Therapy for Kidney Allograft Rejection
AUTHORS:
Richard Fuquay, James Eric Cooper
KEYWORDS:
Cytomegalovirus (Mesh); Arthritis (Mesh); Kidney Transplantation (Mesh); Immunosuppression (Mesh); Chemoprevention (Mesh); Valganciclovir (Mesh)
JOURNAL NAME:
Open Journal of Nephrology,
Vol.2 No.1,
March
28,
2012
ABSTRACT: Cytomegalovirus viremia and tissue-invasive disease are common after kidney transplantation. Chemoprophylaxis has made substantial improvement in this clinical problem. Here we report a 29-year-old woman who had kidney allograft rejection and received lymphocyte-depleting therapy. She presented with a new oligo-arthritis that led to 2 successive arthrocenteses. The etiology of the inflammation could not be determined initially. On the second arthrocentesis, a synovial fluid cytomegalovirus polymerase chain reaction test was positive. The patient responded to treatment with valganciclovir, had negative follow-up serum cytomegalovirus polymerase chain reaction tests, and experienced resolution of her joint inflammation. We review briefly the data for cytomegalovirus chemoprophylaxis, preemptive screening, and treatment recommendations.