Premium
Leflunomide as part of the treatment for multidrug‐resistant cytomegalovirus disease after lung transplantation: case report and review of the literature
Author(s) -
Verkaik N.J.,
Hoek R.A.S.,
Bergeijk H.,
Hal P.Th.W.,
Schipper M.E.I.,
Pas S.D.,
Beersma M.F.C.,
Boucher C.A.B.,
Jedema I.,
Falkenburg F.,
Hoogsteden H.C.,
Blink B.,
Murk J.L.
Publication year - 2013
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12156
Subject(s) - medicine , foscarnet , leflunomide , cidofovir , ganciclovir , cytomegalovirus , immunology , lung transplantation , transplantation , regimen , salvage therapy , virology , human cytomegalovirus , chemotherapy , viral disease , virus , herpesviridae , methotrexate
Treatment of cytomegalovirus ( CMV ) disease in transplant patients is challenging and, with antiviral resistance to first‐line drugs, it remains uncertain which treatment algorithm to follow. Some data suggest that leflunomide, a pyrimidine synthesis inhibitor, can be used to treat resistant CMV infections. We report a 57‐year‐old CMV immunoglobulin‐G (IgG)‐seronegative woman, who received a bilateral lung transplant (LuTx) from a CMV IgG‐positive donor with CMV primary disease. The CMV strain was genotypically resistant to ganciclovir, foscarnet, and cidofovir. After starting leflunomide as add‐on therapy to a multidrug anti‐ CMV regimen, viral load declined substantially in 2 months without adverse events. This experience is discussed against the background of existing literature on the use of leflunomide as an anti‐ CMV agent in LuTx recipients.