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A fatal case of cytomegalovirus ventriculoencephalitis in a mycosis fungoides patient who received multiple umbilical cord blood cell transplantations

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Title: A fatal case of cytomegalovirus ventriculoencephalitis in a mycosis fungoides patient who received multiple umbilical cord blood cell transplantations
Authors: Matsukawa, Toshihiro Browse this author
Goto, Hideki Browse this author
Takahashi, Kenta Browse this author
Asanuma, Shinsuke Browse this author
Yasumoto, Atsushi Browse this author
Takahata, Mutsumi Browse this author
Shigematsu, Akio Browse this author
Endo, Tomoyuki Browse this author
Tanaka, Junji Browse this author
Hashino, Satoshi Browse this author
Tanaka, Shinya Browse this author
Imamura, Masahiro Browse this author
Keywords: Cytomegalovirus ventriculoencephalitis
Ganciclovir resistance
Umbilical cord blood transplantation
Mycosis fungoides
Inclusion-bearing cells
Issue Date: Feb-2012
Publisher: Springer Japan
Journal Title: International Journal of Hematology
Volume: 95
Issue: 2
Start Page: 217
End Page: 222
Publisher DOI: 10.1007/s12185-012-1003-3
PMID: 22262140
Abstract: Cytomegalovirus (CMV) infection is latent in the majority of adult humans. The reactivation of CMV causes pneumonia and gastrointestinal disease in severely immunosuppressed patients, who consequently suffer very high mortality due to CMV central nervous system disease. We report here a case involving a 28-year-old female patient with mycosis fungoides who underwent umbilical cord blood transplantation three times and developed CMV ventriculoencephalitis. The patient's CMV viremia was successfully preempted with ganciclovir (GCV) as indicated by undetectable CMV antigenemia, but despite this successful treatment, the patient developed CMV ventriculoencephalitis. Foscarnet (FCV) therapy led to a temporary recovery, after which CMV ventriculoencephalitis recurred and the patient died after receiving combination GCV and FCV therapy. Autopsy samples revealed CMV ventriculoencephalitis, as indicated by numerous inclusion-bearing cells (Owl's eye). It is likely that this patient harbored a GCV-resistant CMV strain; however, it was not possible to obtain nucleic acids suitable for use in assessing this possibility.
Rights: The final publication is available at www.springerlink.com
Type: article (author version)
URI: http://hdl.handle.net/2115/48608
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 松川 敏大

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