Leflunomide as part of the treatment for multidrug‐resistant cytomegalovirus disease after lung transplantation: case report and review of the literature. Issue 6 (23rd October 2013)

• Record Type: Journal Article
• Authors: Verkaik, N.J.; Hoek, R.A.S.; van, H.; van, 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.; van den, B.; Murk, J.L.
• Is Part Of: Transplant infectious disease. Volume 15:Issue 6(2013)
• Page Start: E243
• Page End: E249
• Publication Date: 2013-10-23
• Subjects: Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.12156
• Languages: English
• ISSNs: 1398-2273

Abstract

<abstract abstract-type="main" id="tid12156-abs-0001"> <title>Abstract</title> <p>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.</p> </abstract>