Gudnason T, Belani K K, Balfour H H
Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis 55455.
Pediatr Infect Dis J. 1989 Jul;8(7):436-40. doi: 10.1097/00006454-198907000-00006.
Twelve immunocompromised children were treated with 13 courses of intravenously administered ganciclovir for severe cytomegalovirus disease. All children were allograft recipients; 6 received organ transplants (5 liver, 1 kidney) and 6 received bone marrow. They presented with one or more of the following forms of cytomegalovirus disease: pneumonitis, 9; hepatitis, 3; colitis, 2; peritonitis, 1; and retinitis, 1. Clinical improvement was observed in 7 (58%) of 12 patients during ganciclovir therapy. Cessation of active viral replication during therapy accompanied 69% of the treatment courses. Mild and transient increases in creatinine and liver function tests and/or decreases in neutrophil count accompanied 77% of treatment courses but neutropenia (less than 1000 cells/mm3) did not occur. Transient decreases in platelet counts accompanied therapy in 3 bone marrow allograft recipients, but greater than 50% decrease in lymphocyte count was not seen. We conclude that ganciclovir is safe and appears to have a beneficial effect on cytomegalovirus disease in some pediatric transplant recipients.
12名免疫功能低下的儿童接受了13个疗程的静脉注射更昔洛韦治疗严重巨细胞病毒病。所有儿童均为同种异体移植受者；6名接受了器官移植（5例肝脏、1例肾脏），6名接受了骨髓移植。他们表现出以下一种或多种形式的巨细胞病毒病：肺炎9例；肝炎3例；结肠炎2例；腹膜炎1例；视网膜炎1例。在更昔洛韦治疗期间，12例患者中有7例（58%）观察到临床改善。治疗期间69%的疗程出现病毒复制停止。77%的疗程伴有肌酐和肝功能检查轻度短暂升高和/或中性粒细胞计数下降，但未发生中性粒细胞减少（低于1000个细胞/mm³）。3例骨髓同种异体移植受者在治疗期间血小板计数短暂下降，但未观察到淋巴细胞计数下降超过50%。我们得出结论，更昔洛韦是安全的，并且在一些儿科移植受者中似乎对巨细胞病毒病有有益作用。
