Lino Katia, Trizzotti Natalia, Carvalho Fabiana Rabe, Cosendey Rachel Ingrid, Souza Cintia Fernandes, Klumb Evandro Mendes, Silva Andrea Alice, Almeida Jorge Reis
Universidade Federal Fluminense, Niterói, RJ, Brasil.
Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
J Bras Nefrol. 2018 Jan-Mar;40(1):44-52. doi: 10.1590/2175-8239-JBN-3838. Epub 2018 Apr 26.
In contrast to organ transplantation, few studies correlate the monitoring of pp65 antigenemia with a diagnosis of cytomegalovirus (CMV) in patients with systemic lupus erythematosus (SLE).
To highlight the importance of CMV outside transplantation, we monitored pp65 antigenemia in a series of SLE patients.
From March 2015 to March 2016, SLE patients presenting kidney involvement, fever, and an unclear infection at hospital admission were monitored through pp65 antigenemia. The pp65 antigenemia assay, revealed by immunofluorescence, was correlated with clinical and laboratory findings.
We included 19 patients with a suspected unclear infection. A positivity for pp65 antigenemia was found in seven patients (36.8%). The mean age was 33.5 ± 11.2 years, 16 (84%) were females, and 16 (84%) were black. Lymphopenia, anemia, and higher scores of SLEDAI were significantly more common in pp65-positive patients. Five patients received antiviral therapy with ganciclovir. Although receiving specific CMV treatment, one patient died because of suspected CMV disease.
Pp65 antigenemia might be relevant in SLE patients, and studies with a greater number of patients are needed in order to establish sensitivity and specificity of pp65 antigenemia in different clinical contexts of SLE patients.
与器官移植不同，很少有研究将pp65抗原血症监测与系统性红斑狼疮（SLE）患者的巨细胞病毒（CMV）诊断相关联。
为强调移植外CMV的重要性，我们对一系列SLE患者监测了pp65抗原血症。
2015年3月至2016年3月，对入院时出现肾脏受累、发热且感染情况不明的SLE患者通过pp65抗原血症进行监测。通过免疫荧光显示的pp65抗原血症检测与临床和实验室检查结果相关。
我们纳入了19例疑似不明感染的患者。7例患者（36.8%）pp65抗原血症呈阳性。平均年龄为33.5±11.2岁，16例（84%）为女性，16例（84%）为黑人。淋巴细胞减少、贫血以及更高的SLEDAI评分在pp65阳性患者中显著更为常见。5例患者接受了更昔洛韦抗病毒治疗。尽管接受了特异性CMV治疗，但1例患者因疑似CMV疾病死亡。
Pp65抗原血症在SLE患者中可能具有相关性，需要开展更多患者的研究以确定pp65抗原血症在SLE患者不同临床情况下的敏感性和特异性。
