Kaulfersch W, Urban C, Hauer C, Lackner H, Gamillscheg A, Slavc I, Langmann G
Department of Pediatrics, University of Graz, Austria.
Bone Marrow Transplant. 1989 Sep;4(5):587-9.
Cytomegalovirus (CMV) infection of the retina is a well recognized complication in patients with the acquired immune deficiency syndrome but is rarely seen after bone marrow transplantation (BMT). Among a variety of drugs ganciclovir so far appears to be the most effective therapy for CMV retinitis, but in previous studies relapses occurred in all patients in whom ganciclovir was interrupted. We report the clinical findings in a 22-year-old BMT recipient who developed bilateral exudative CMV retinitis 64 days after BMT despite prophylactic treatment with high-titer CMV-immunoglobulins and transfusions of CMV-negative blood products and donor bone marrow. During a 12 day course of treatment with 7.5 mg/kg/day of ganciclovir the CMV retinitis improved and viruria ceased on day 4 of therapy. In contrast to the previous reports, CMV retinitis in this patient continued to improve even after ganciclovir was stopped and eventually complete healing of all intraretinal lesions as well as total reconstitution of the visual acuity was achieved. He is now free of disease and without relapse of CMV retinitis more than 1 year after transplantation.
视网膜巨细胞病毒（CMV）感染在获得性免疫缺陷综合征患者中是一种公认的并发症，但在骨髓移植（BMT）后很少见。在各种药物中，更昔洛韦似乎是治疗CMV视网膜炎最有效的药物，但在以往的研究中，所有中断更昔洛韦治疗的患者均出现复发。我们报告了一名22岁BMT受者的临床情况，该患者在BMT后64天发生双侧渗出性CMV视网膜炎，尽管接受了高滴度CMV免疫球蛋白预防性治疗以及输注CMV阴性血液制品和供体骨髓。在接受7.5mg/kg/天更昔洛韦治疗的12天疗程中，CMV视网膜炎有所改善，治疗第4天病毒尿停止。与以往报告不同的是，该患者的CMV视网膜炎在停用更昔洛韦后仍持续改善，最终视网膜内所有病变完全愈合，视力完全恢复。移植后1年多来，他目前无病，CMV视网膜炎未复发。
