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Published on: May 27, 2011
Severe CMV complication following maintenance therapy with rituximab
Lenaïg Le Clech1, Jean-Christophe Ianotto, Isabelle Quintin-Roue
1Department of Clinical Haematology, Institute of Cancerology and Hematology, University Hospital Brest, Brest, France. lenaig.leclech@hotmail.fr
BMJ Case Reports
|January 12, 2013
Summary
Cytomegalovirus (CMV) encephalitis is a rare infection in immunocompromised patients. This case highlights CMV gastritis and encephalitis following chemotherapy and rituximab treatment for chronic lymphocytic leukemia (CLL).
Area of Science:
- Infectious Diseases
- Onco-immunology
- Neurology
Background:
- Cytomegalovirus (CMV) infections are a significant concern in immunocompromised individuals, particularly those with HIV.
- CMV encephalitis is a rare but serious neurological complication.
- Monoclonal antibodies, such as rituximab, used in treating hematological malignancies, have been associated with opportunistic infections like CMV.
Observation:
- This report details a patient diagnosed with chronic lymphocytic leukemia (CLL).
- The patient underwent chemotherapy followed by maintenance therapy with rituximab.
- Following treatment, the patient developed both CMV gastritis and subsequently CMV encephalitis.
Findings:
- The clinical presentation involved gastrointestinal symptoms indicative of CMV gastritis.
- The neurological progression led to a diagnosis of CMV encephalitis.
- This sequence suggests a potential link between rituximab-based therapy and the development of CMV disease in CLL patients.
Implications:
- This case underscores the importance of vigilance for opportunistic CMV infections in patients receiving rituximab for CLL.
- Early diagnosis and management of CMV gastritis and encephalitis are crucial for patient outcomes.
- Further research may be warranted to elucidate the precise mechanisms and risk factors for CMV reactivation during CLL treatment.
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