TY - JOUR
T1 - Incidence and clinical features of cytomegalovirus infection diagnosed by cytomegalovirus pp65 antigenemia assay during high dose corticosteroid therapy for collagen vascular diseases
AU - Yamashita, Masahiro
AU - Ishii, Tomonori
AU - Iwama, Noriyuki
AU - Takahashi, Hiroshi
PY - 2006/11
Y1 - 2006/11
N2 - Objective: To investigate the incidence and clinical features in patients with cytomegalovirus (CMV)-positive antigenemia during high dose corticosteroid therapy for collagen vascular diseases, and risk factors associated with it. Patients and methods: We examined retrospectively 35 consecutive patients for the presence of CMV-positive pp65 antigenemia. The patients were admitted to Saka General Hospital from 2000 to 2003, and were administered more than 0.5 mg/kg of body weight/day of peroral prednisolone for collagen vascular diseases. Characteristics of patients with and without CMV-positive antigenemia were compared. Results: CMV-positive antigenemia was detected in 14 patients (40.0%), including six with microscopic polyangitis, three with rheumatoid arthritis, and five with other conditions. Three patients (8.6%) were diagnosed as having a CMV disease: pneumonitis or encephalitis. Symptoms and laboratory findings, including slight fever and a low increase in levels of hepatic enzymes and cytopenia, were observed in 10 of the 14 patients. Two patients died of CMV diseases refractory to ganciclovir. Ages of more than 70 years old were associated with the presence of CMV-positive antigenemia (relative risk = 4.5, 95% confidence interval = 1.14-17.6). Conclusion: CMV infection diagnosed by CMV pp65 antigenemia assay is not rare during high dose corticosteroid therapy for collagen vascular diseases, and advanced age is considered a risk factor for it. It has a variety of symptoms and laboratory findings, which are mild and nonspecific to this type of infection, and they may not be clearly noted as clinical signs of CMV infection, even in patients with CMV diseases whose prognoses can be unsatisfactory. During high dose corticosteroid therapy for collagen vascular diseases, careful attention should be paid to CMV infection.
AB - Objective: To investigate the incidence and clinical features in patients with cytomegalovirus (CMV)-positive antigenemia during high dose corticosteroid therapy for collagen vascular diseases, and risk factors associated with it. Patients and methods: We examined retrospectively 35 consecutive patients for the presence of CMV-positive pp65 antigenemia. The patients were admitted to Saka General Hospital from 2000 to 2003, and were administered more than 0.5 mg/kg of body weight/day of peroral prednisolone for collagen vascular diseases. Characteristics of patients with and without CMV-positive antigenemia were compared. Results: CMV-positive antigenemia was detected in 14 patients (40.0%), including six with microscopic polyangitis, three with rheumatoid arthritis, and five with other conditions. Three patients (8.6%) were diagnosed as having a CMV disease: pneumonitis or encephalitis. Symptoms and laboratory findings, including slight fever and a low increase in levels of hepatic enzymes and cytopenia, were observed in 10 of the 14 patients. Two patients died of CMV diseases refractory to ganciclovir. Ages of more than 70 years old were associated with the presence of CMV-positive antigenemia (relative risk = 4.5, 95% confidence interval = 1.14-17.6). Conclusion: CMV infection diagnosed by CMV pp65 antigenemia assay is not rare during high dose corticosteroid therapy for collagen vascular diseases, and advanced age is considered a risk factor for it. It has a variety of symptoms and laboratory findings, which are mild and nonspecific to this type of infection, and they may not be clearly noted as clinical signs of CMV infection, even in patients with CMV diseases whose prognoses can be unsatisfactory. During high dose corticosteroid therapy for collagen vascular diseases, careful attention should be paid to CMV infection.
KW - Clinical features
KW - Collagen vascular diseases
KW - Cytomegalovirus infection
KW - Cytomegalovirus pp65 antigenemia
KW - Risk factors
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M3 - Article
C2 - 17207380
AN - SCOPUS:33846417630
VL - 24
SP - 649
EP - 655
JO - Clinical and Experimental Rheumatology
JF - Clinical and Experimental Rheumatology
SN - 0392-856X
IS - 6
ER -