Skip to main content
Top
Published in: Rheumatology International 1/2012

01-01-2012 | Short Communication

Leflunomide use in a cytomegalovirus infection of a patient with dermatomyositis

Authors: Alberto O. Orden, Juan C. Chuluyan, Ana C. Colombini, Rubén F. Barbera

Published in: Rheumatology International | Issue 1/2012

Login to get access

Abstract

Human cytomegalovirus (CMV) is responsible for significant morbidity and mortality in immunocompromised populations, such as those suffering from dermatomyositis (DM). We present here a case study of a DM patient undergoing methotrexate treatment who presents with weakness, myalgia, elevated levels of hepatic transaminases and serological markers of CMV primo-infection. The antiviral activity of leflunomide against CMV was described recently. The use of leflunomide as an immunomodulator may have contributed to the satisfactory evolution of the treatment for a symptomatic CMV infection in an immunocompromised patient, since the typical treatment outcome is more prolonged and with additional complications.
Literature
1.
go back to reference Hashimoto A, Okuyama R, Watanabe H, Tagami H, Aiba S (2006) Cytomegalovirus infection complicating immunosuppressive therapy for dermatomyositis. Acta Derm Venereol 86(6):535–537PubMed Hashimoto A, Okuyama R, Watanabe H, Tagami H, Aiba S (2006) Cytomegalovirus infection complicating immunosuppressive therapy for dermatomyositis. Acta Derm Venereol 86(6):535–537PubMed
2.
go back to reference Takizawa Y, Inokuma S, Tanaka Y, Saito K, Atsumi T, Hirakata M, Kameda H, Hirohata S, Kondo H, Kumagai S, Tanaka Y (2008) Clinical characteristics of cytomegalovirus infection in rheumatic diseases: multicentre survey in a large patient population. Rheumatology (Oxford) 47(9):1373–1378 Takizawa Y, Inokuma S, Tanaka Y, Saito K, Atsumi T, Hirakata M, Kameda H, Hirohata S, Kondo H, Kumagai S, Tanaka Y (2008) Clinical characteristics of cytomegalovirus infection in rheumatic diseases: multicentre survey in a large patient population. Rheumatology (Oxford) 47(9):1373–1378
3.
go back to reference Steininger C (2007) Novel therapies for cytomegalovirus disease. Recent Patents Anti-Infect Drug Disc 2(1):53–72 Steininger C (2007) Novel therapies for cytomegalovirus disease. Recent Patents Anti-Infect Drug Disc 2(1):53–72
4.
go back to reference Waldman WJ, Knight DA, Blinder L, Shen J, Lurain NS, Miller DM, Sedmak DD, Williams JW, Chong AS (1999) Inhibition of cytomegalovirus in vitro and in vivo by the experimental immunosuppressive agent leflunomide. Intervirology 42(5–6):412–418PubMed Waldman WJ, Knight DA, Blinder L, Shen J, Lurain NS, Miller DM, Sedmak DD, Williams JW, Chong AS (1999) Inhibition of cytomegalovirus in vitro and in vivo by the experimental immunosuppressive agent leflunomide. Intervirology 42(5–6):412–418PubMed
5.
go back to reference Chong AS, Zeng H, Knight DA, Shen J, Meister GT, Williams JW, Waldman WJ (2006) Concurrent antiviral and immunosuppressive activities of leflunomide in vivo. Am J Transplant 6(1):69–75PubMed Chong AS, Zeng H, Knight DA, Shen J, Meister GT, Williams JW, Waldman WJ (2006) Concurrent antiviral and immunosuppressive activities of leflunomide in vivo. Am J Transplant 6(1):69–75PubMed
6.
go back to reference John GT, Manivannan J, Chandy S, Peter S, Fleming DH, Chandy SJ, Balakrishnan N, Krishnamurthy K, Kirubakaran MG, Jacob CK (2005) A prospective evaluation of leflunomide therapy for cytomegalovirus disease in renal transplant recipients. Transplant Proc 37(10):4303–4305PubMed John GT, Manivannan J, Chandy S, Peter S, Fleming DH, Chandy SJ, Balakrishnan N, Krishnamurthy K, Kirubakaran MG, Jacob CK (2005) A prospective evaluation of leflunomide therapy for cytomegalovirus disease in renal transplant recipients. Transplant Proc 37(10):4303–4305PubMed
7.
go back to reference Leca N (2009) Leflunomide use in renal transplantation. Curr Opin Organ Transplant 14(4):370–374PubMed Leca N (2009) Leflunomide use in renal transplantation. Curr Opin Organ Transplant 14(4):370–374PubMed
8.
go back to reference Sangle VS, Sangle SR, D’Cruz DP (2008) Leflunomide as a remission-maintaining therapy in difficult-to-treat dermatomyositis. Ann Rheum Dis 67(5):723PubMed Sangle VS, Sangle SR, D’Cruz DP (2008) Leflunomide as a remission-maintaining therapy in difficult-to-treat dermatomyositis. Ann Rheum Dis 67(5):723PubMed
9.
go back to reference Evers DL, Wang X, Huong SM, Andreoni KA, Huang ES (2005) Inhibition of human cytomegalovirus signaling, replication by the immunosuppressant FK778. Antiviral Res 65(1):1–12PubMed Evers DL, Wang X, Huong SM, Andreoni KA, Huang ES (2005) Inhibition of human cytomegalovirus signaling, replication by the immunosuppressant FK778. Antiviral Res 65(1):1–12PubMed
10.
go back to reference Avery RK (2008) Update in management of ganciclovir-resistant cytomegalovirus infection. Curr Opin Infect Dis 21(4):433–437PubMed Avery RK (2008) Update in management of ganciclovir-resistant cytomegalovirus infection. Curr Opin Infect Dis 21(4):433–437PubMed
11.
go back to reference Araya CE, Garin EH, Neiberger RE, Dharnidharka VR (2010) Leflunomide therapy for BK virus allograft nephropathy in pediatric, young adult kidney transplant recipients. Pediatr Transplant 14(1):145–150PubMed Araya CE, Garin EH, Neiberger RE, Dharnidharka VR (2010) Leflunomide therapy for BK virus allograft nephropathy in pediatric, young adult kidney transplant recipients. Pediatr Transplant 14(1):145–150PubMed
12.
go back to reference Teschner S, Gerke P, Geyer M, Wilpert J, Krumme B, Benzing T, Walz G (2009) Leflunomide therapy for polyomavirus-induced allograft nephropathy: efficient BK virus elimination without increased risk of rejection. Transplant Proc 41(6):2533–2538PubMed Teschner S, Gerke P, Geyer M, Wilpert J, Krumme B, Benzing T, Walz G (2009) Leflunomide therapy for polyomavirus-induced allograft nephropathy: efficient BK virus elimination without increased risk of rejection. Transplant Proc 41(6):2533–2538PubMed
13.
go back to reference Ehlert K, Groll AH, Kuehn J, Vormoor J (2006) Treatment of refractory CMV-infection following hematopoietic stem cell transplantation with the combination of foscarnet, leflunomide. Klin Padiatr 218(3):180–184PubMed Ehlert K, Groll AH, Kuehn J, Vormoor J (2006) Treatment of refractory CMV-infection following hematopoietic stem cell transplantation with the combination of foscarnet, leflunomide. Klin Padiatr 218(3):180–184PubMed
14.
go back to reference Battiwalla M, Paplham P, Almyroudis NG, McCarthy A, Abdelhalim A, Elefante A, Smith P, Becker J, McCarthy PL, Segal BH (2007) Leflunomide failure to control recurrent cytomegalovirus infection in the setting of renal failure after allogeneic stem cell transplantation. Transpl Infect Dis 9(1):28–32PubMed Battiwalla M, Paplham P, Almyroudis NG, McCarthy A, Abdelhalim A, Elefante A, Smith P, Becker J, McCarthy PL, Segal BH (2007) Leflunomide failure to control recurrent cytomegalovirus infection in the setting of renal failure after allogeneic stem cell transplantation. Transpl Infect Dis 9(1):28–32PubMed
15.
go back to reference John GT, Manivannan J, Chandy S, Peter S, Jacob CK (2004) Leflunomide therapy for cytomegalovirus disease in renal allograft recepients. Transplantation. 15; 77(9):1460–1 John GT, Manivannan J, Chandy S, Peter S, Jacob CK (2004) Leflunomide therapy for cytomegalovirus disease in renal allograft recepients. Transplantation. 15; 77(9):1460–1
Metadata
Title
Leflunomide use in a cytomegalovirus infection of a patient with dermatomyositis
Authors
Alberto O. Orden
Juan C. Chuluyan
Ana C. Colombini
Rubén F. Barbera
Publication date
01-01-2012
Publisher
Springer-Verlag
Published in
Rheumatology International / Issue 1/2012
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-010-1786-6

Other articles of this Issue 1/2012

Rheumatology International 1/2012 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.