Disseminated cytomegalovirus infection complicating active treatment of systemic lupus erythematosus: an emerging problem

Patients with systemic lupus erythematosus (SLE) often require immunosuppression to induce remission of active disease exacerbations. Over the past two decades, treatment modalities for this condition have emerged leading to improved morbidity from disease related outcomes. However, as a result, inf...

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Bibliographic Details
Published in:Lupus 2017-04, Vol.26 (4), p.431-434
Main Authors: Berman, N, Belmont, H M
Format: Article
Language:English
Subjects:
Adult
Alkylating Agents - therapeutic use
Antimetabolites - adverse effects
Antimetabolites - therapeutic use
Autoimmune diseases
Cytomegalovirus
Cytomegalovirus Infections - diagnosis
Disease Management
Female
Humans
Immunology
Immunosuppression
Immunosuppression - adverse effects
Immunosuppression - methods
Lupus
Lupus Erythematosus, Systemic - drug therapy
Lupus Erythematosus, Systemic - immunology
Lupus Erythematosus, Systemic - virology
Middle Aged
Steroids - adverse effects
Steroids - therapeutic use
Systemic lupus erythematosus
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Summary:Patients with systemic lupus erythematosus (SLE) often require immunosuppression to induce remission of active disease exacerbations. Over the past two decades, treatment modalities for this condition have emerged leading to improved morbidity from disease related outcomes. However, as a result, infection risks and patterns have changed, leading to higher rates of opportunistic infections among this population. We report four cases of cytomegalovirus (CMV) in patients with SLE who received immunosuppressive therapy, including pulse steroids, antimetabolites such as mycophenolate mofetil, and alkylating agents such as cyclophosphamide. We propose that given the rise in prevalence of CMV, there is a need for appropriate screening for this opportunistic pathogen and studies to determine the risks and benefits of prophylactic or preemptive treatment for this virus.
ISSN:0961-2033
1477-0962
DOI:10.1177/0961203316671817