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Journal of Medical Case Reports
Published in: Journal of Medical Case Reports 1/2014

Open Access 01-12-2014 | Case report

Chlorambucil-induced cytomegalovirus infection: a case report

Authors: María Thiscal López-Lluva, María Dolores Sanchez de la Nieta-García, Jesús Piqueras-Flores, Minerva Arambarri-Segura, Alberto Martínez-Calero, Francisco Rivera-Hernández

Published in: Journal of Medical Case Reports | Issue 1/2014

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Abstract

Introduction

Chlorambucil is an alkylating agent used in combination with prednisolone for the treatment of idiopathic membranous nephropathy. Although chlorambucil is generally well-tolerated, it is a myelosuppresive drug that can cause several infections.

Case presentation

We report the case of an 81-year-old Caucasian male presenting with idiopathic membranous nephropathy who developed fever, cough, dyspnea, pulmonary infiltrates, and abdominal pain shortly after the initiation of treatment with chlorambucil and corticosteroids for nephropathy. Virology tests for infectious diseases revealed a recent cytomegalovirus infection. Antiviral treatment (ganciclovir) resulted in full remission.

Conclusions

Cytomegalovirus infection should be considered in the differential diagnosis of respiratory symptoms and pulmonary infiltrates in patients treated with chlorambucil for nephrotic syndrome.
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Literature
1.
Kidney Disease: Improving Global Outcomes (KDIGO) Glomerulonephritis Work Group: KDIGO Clinical Practice Guideline for Glomerulonephritis. Kidney Int Suppl. 2012, 2: 139-274.CrossRef
2.
Cattran DC: Idiopathic membranous nephropathy. Kidney Int. 2001, 59: 1983-1994. 10.1046/j.1523-1755.2001.0590051983.x.CrossRefPubMed
3.
Cattran DC: Management of membranous nephropathy: when and what for treatment. J Am Soc Nephrol. 2005, 16: 1188-1194. 10.1681/ASN.2005010028.CrossRefPubMed
4.
Davison AM, Cameron JS, Kerr DN, Ogg CS, Wilkinson RW: The natural history of renal function in untreated idiopathic membranous glomerulonephritis in adults. Clin Nephrol. 1984, 22: 61-67.PubMed
5.
Du Buf-Vereijken PW, Branten AJW, Wetzels JFM: Idiopathic membranous nephropathy: outline and rationale of a treatment strategy. Am J Kidney Dis. 2005, 46: 1012-1029. 10.1053/j.ajkd.2005.08.020.CrossRefPubMed
6.
Ponticelli C, Zucchelli P, Imbasciati E, Cagnoli L, Pozzi C, Passerini P, Grassi C, Limido D, Pasquali S, Volpini T, Sasdelli M, Locatelli F: Controlled trial of methylprednisolone and chlorambucil in idiopathic membranous nephropathy. N Engl J Med. 1984, 310: 946-950. 10.1056/NEJM198404123101503.CrossRefPubMed
7.
Passerini P, Ponticelli C: Corticosteroids, cyclophosphamide and chlorambucil therapy of membranous nephropathy. Semin Nephrol. 2003, 23: 355-361. 10.1016/S0270-9295(03)00052-4.CrossRefPubMed
8.
Idasiak-Piechocka I, Oko A, Lochynska-Bielecka K, Skrobanska B: Efficacy and safety of lowdose chlorambucil in nephrotic patients with idiopathic membranous nephropathy. Kidney Blood Press Res. 2009, 32: 263-267. 10.1159/000239539.CrossRefPubMed
9.
Khong HT, McCarthy J: Chlorambucil-induced pulmonary disease: a case report and review of the literature. Ann Hematol. 1998, 77 (1–2): 85-CrossRefPubMed
10.
Crestani B, Jaccard A, Isral-Biet D, Couderc LJ, Frija J, Clauvel JP: Chlorambucil-associated pneumonitis. Chest. 1994, 105: 634-10.1378/chest.105.2.634.CrossRefPubMed
11.
Torres A, Dominguez-Gil B, Carreno A, Hernández E, Morales E, Segura J, González E, Praga M: Conservative versus immunosuppressive treatment of patients with idiopathic membranous nephropathy. Kidney Int. 2002, 61: 219-227. 10.1046/j.1523-1755.2002.00124.x.CrossRefPubMed
Metadata
Title
Chlorambucil-induced cytomegalovirus infection: a case report
Authors
María Thiscal López-Lluva
María Dolores Sanchez de la Nieta-García
Jesús Piqueras-Flores
Minerva Arambarri-Segura
Alberto Martínez-Calero
Francisco Rivera-Hernández
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2014
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-8-280

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