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Complete remission of VZV reactivation treated with valganciclovir in a patient with total lymphocyte depletion and acute kidney injury after allogeneic bone marrow transplantation
Author(s) -
Maximova Natalia,
Antonio Pizzol,
Marilena Granzotto,
Rovere Francesca,
Tamaro Paolo
Publication year - 2015
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/apm.12303
Subject(s) - valganciclovir , medicine , ganciclovir , foscarnet , transplantation , chickenpox , varicella zoster virus , gastroenterology , immunology , hematopoietic stem cell transplantation , kidney transplantation , surgery , virus , human cytomegalovirus
Varicella zoster virus ( VZV ), a threat for hematopoietic stem cell transplantation ( HSCT ) recipients, is still one of the most common viral pathogens that affect these patients with a reported incidence ranging between 17% and 50% in the post transplantation period. Valganciclovir (V‐ GCV ), a valine ester pro‐drug of GCV orally administrable, has recently shown great activity against CMV infections, but there are no reports of its clinical efficacy against VZV . We here report a case history of a patient with positive serologic test for VZV , who underwent allogeneic HSCT and developed an atypical varicella‐like illness. First‐line therapy with foscarnet had to be discontinued due rapid development of renal impairment (creatinine: 2.60 mg/dL, urea: 130.6 mg/dL) and therefore was switched to V‐ GCV . The renal impairment and skin lesions of the patient fully recovered after few days of therapy, even though the patient had complete lymphocyte depletion. This is the first case of a patient with chickenpox‐like illness treated successfully with V‐ GCV .