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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2019.1
- 수록면
- 273 - 277 (5page)
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Patients with severe active lupus nephritis (LN) require immunosuppressive therapy to induce remission. However, the development of profound hypogammaglobulinemia causing cytomegalovirus (CMV) disease is a rare occurrence during standard immunotherapy. A 27-year-old woman who presented with active LN along with moderate renal impairment was treated with of mycophenolate mofetil (MMF) and methylprednisolone. MMF was soon switched with low-dose intravenous (IV) cyclophosphamide (CYC) owing to the development of posterior reversible encephalopathy syndrome and deterioration of renal function requiring hemodialysis. After two cycles of IV CYC, she developed CMV colitis and pneumonia. Although her serum immunoglobulin (Ig) concentrations before receiving immunosuppressive treatment were normal, they were profoundly reduced at CMV disease onset and continued to maintain low level for 30 months. Severe hypogammaglobulinemia can occur during standard therapy for LN, especially in patients with impaired renal function, pointing out the importance of close monitoring of Ig levels and CMV infection.
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참고문헌 (15)
참고문헌 신청
Cervera R / 2003 / Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients / Medicine 82:299~308
Hahn BH / 2012 / American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis / Arthritis Care Res 64:797~808
Bertsias GK / 2012 / Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis / Ann Rheum Dis 71:1771~1782
Ljungman P / 2002 / Definitions of cytomegalovirus infection and disease in transplant recipients / Clin Infect Dis 34:1094~1097
Mawhorter S / 2008 / Hypogammaglobulinemia and infection risk in solid organ transplant recipients / Curr Opin Organ Transplant 13:581~585
Hahn BH / 2012 / American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis / Arthritis Care Res 64:797~808
Bertsias GK / 2012 / Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis / Ann Rheum Dis 71:1771~1782
Ljungman P / 2002 / Definitions of cytomegalovirus infection and disease in transplant recipients / Clin Infect Dis 34:1094~1097
Mawhorter S / 2008 / Hypogammaglobulinemia and infection risk in solid organ transplant recipients / Curr Opin Organ Transplant 13:581~585
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