Belatacept associated - cytomegalovirus retinitis in a kidney transplant recipient: a case report and review of the literature
Abstract Background To report the first case of belatacept-associated multidrug-resistant Cytomegalovirus retinitis in a kidney transplant recipient. Case presentation A 76-year-old African male renal allograft recipient was admitted for acute visual loss of the right eye. Ophthalmological examinati...
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doaj-9c68155e18e24dc5a93183ce4bb4ca522020-12-06T12:24:04ZengBMCBMC Ophthalmology1471-24152020-12-012011510.1186/s12886-020-01741-1Belatacept associated - cytomegalovirus retinitis in a kidney transplant recipient: a case report and review of the literaturePierre-Guillaume Deliège0Justine Bastien1Laetitia Mokri2Charlotte Guyot-Colosio3Carl Arndt4Philippe Rieu5Division of Nephrology, University Hospital of ReimsDivision of Ophtalmology, University Hospital of ReimsDivision of Nephrology, University Hospital of ReimsDivision of Nephrology, University Hospital of ReimsDivision of Ophtalmology, University Hospital of ReimsDivision of Nephrology, University Hospital of ReimsAbstract Background To report the first case of belatacept-associated multidrug-resistant Cytomegalovirus retinitis in a kidney transplant recipient. Case presentation A 76-year-old African male renal allograft recipient was admitted for acute visual loss of the right eye. Ophthalmological examination of the right eye showed anterior uveitis and vitritis associated with large paravascular haemorrhages and yellow necrotic borders, involving the posterior pole but not the fovea. Both Cytomegalovirus DNA in plasma and aqueous humor were positive. The patient had had several episodes of Cytomegalovirus reactivation subsequent to the introduction of belatacept. His cytomegalovirus was multi-drug resistant, and was treated with maribarir, intravitreal and systemic injections of foscarnet, and anti-Cytomegalovirus human immunoglobulin. In parallel, belatacept was stopped and switched to tacrolimus. Cytomegalovirus DNA became undetectable and there was partial improvement of visual acuity at the last ophthalmologic examination, 18 months after the initial diagnosis of Cytomegalovirus retinitis. Conclusion Cytomegalovirus retinitis is an uncommon opportunistic infection in kidney transplant recipients. Cytomegalovirus retinitis is a serious infection because of the risk of blindness and the occurrence of associated life-threatening opportunistic infections. In view of the recent literature, kidney transplant recipients treated by belatacept immunosuppression may be at increased risk for Cytomegalovirus disease, notably Cytomegalovirus retinitis. The occurrence of Cytomegalovirus retinitis may help improve the selection of patients converted to belatacept.https://doi.org/10.1186/s12886-020-01741-1CytomegalovirusCMVRetinitisKidney transplantationBelatacept |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pierre-Guillaume Deliège Justine Bastien Laetitia Mokri Charlotte Guyot-Colosio Carl Arndt Philippe Rieu |
spellingShingle |
Pierre-Guillaume Deliège Justine Bastien Laetitia Mokri Charlotte Guyot-Colosio Carl Arndt Philippe Rieu Belatacept associated - cytomegalovirus retinitis in a kidney transplant recipient: a case report and review of the literature BMC Ophthalmology Cytomegalovirus CMV Retinitis Kidney transplantation Belatacept |
author_facet |
Pierre-Guillaume Deliège Justine Bastien Laetitia Mokri Charlotte Guyot-Colosio Carl Arndt Philippe Rieu |
author_sort |
Pierre-Guillaume Deliège |
title |
Belatacept associated - cytomegalovirus retinitis in a kidney transplant recipient: a case report and review of the literature |
title_short |
Belatacept associated - cytomegalovirus retinitis in a kidney transplant recipient: a case report and review of the literature |
title_full |
Belatacept associated - cytomegalovirus retinitis in a kidney transplant recipient: a case report and review of the literature |
title_fullStr |
Belatacept associated - cytomegalovirus retinitis in a kidney transplant recipient: a case report and review of the literature |
title_full_unstemmed |
Belatacept associated - cytomegalovirus retinitis in a kidney transplant recipient: a case report and review of the literature |
title_sort |
belatacept associated - cytomegalovirus retinitis in a kidney transplant recipient: a case report and review of the literature |
publisher |
BMC |
series |
BMC Ophthalmology |
issn |
1471-2415 |
publishDate |
2020-12-01 |
description |
Abstract Background To report the first case of belatacept-associated multidrug-resistant Cytomegalovirus retinitis in a kidney transplant recipient. Case presentation A 76-year-old African male renal allograft recipient was admitted for acute visual loss of the right eye. Ophthalmological examination of the right eye showed anterior uveitis and vitritis associated with large paravascular haemorrhages and yellow necrotic borders, involving the posterior pole but not the fovea. Both Cytomegalovirus DNA in plasma and aqueous humor were positive. The patient had had several episodes of Cytomegalovirus reactivation subsequent to the introduction of belatacept. His cytomegalovirus was multi-drug resistant, and was treated with maribarir, intravitreal and systemic injections of foscarnet, and anti-Cytomegalovirus human immunoglobulin. In parallel, belatacept was stopped and switched to tacrolimus. Cytomegalovirus DNA became undetectable and there was partial improvement of visual acuity at the last ophthalmologic examination, 18 months after the initial diagnosis of Cytomegalovirus retinitis. Conclusion Cytomegalovirus retinitis is an uncommon opportunistic infection in kidney transplant recipients. Cytomegalovirus retinitis is a serious infection because of the risk of blindness and the occurrence of associated life-threatening opportunistic infections. In view of the recent literature, kidney transplant recipients treated by belatacept immunosuppression may be at increased risk for Cytomegalovirus disease, notably Cytomegalovirus retinitis. The occurrence of Cytomegalovirus retinitis may help improve the selection of patients converted to belatacept. |
topic |
Cytomegalovirus CMV Retinitis Kidney transplantation Belatacept |
url |
https://doi.org/10.1186/s12886-020-01741-1 |
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