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La meningitis aséptica nosocomial asociada con la administración de OKT3
M A Martin1, R M Massanari, D D Nghiem
1Department of Medicine, University of Iowa College of Medicine, Iowa City.
JAMA
|April 1, 1988
Resumen
La meningitis aséptica ocurrió en pacientes con trasplante renal tratados con el anticuerpo monoclonal murino OKT3 (muromonab-CD3) para el rechazo agudo del alogranto. Esta condición se asoció fuertemente con la administración de OKT3 y parecía ser autolimitada.
Área de la Ciencia:
- Nefrología Nefrología.
- Inmunología Inmunología.
- Enfermedades infecciosas Enfermedades infecciosas.
Sus antecedentes:
- La meningitis aséptica nosocomial es una complicación rara en pacientes inmunocomprometidos.
- El anticuerpo monoclonal murino OKT3 (muromonab-CD3) se utiliza para tratar el rechazo renal agudo del aloinjerto.
- Se observó un brote de meningitis en receptores de trasplante renal.
Objetivo del estudio:
- Para investigar un brote de meningitis aséptica en personas que han recibido un aloinjerto renal.
- Para identificar posibles factores de riesgo para la meningitis en pacientes trasplantados.
- Para determinar la asociación entre la terapia OKT3 y la meningitis aséptica.
Principales métodos:
- Estudio retrospectivo de casos y controles en el que se compararon pacientes con y sin meningitis.
- Se realizaron cultivos de líquido cefalorraquídeo para descartar causas infecciosas.
- Se implementó la vigilancia prospectiva de la meningitis en pacientes que recibieron OKT3.
Principales resultados:
- Cuatro receptores de alogestión renal desarrollaron meningitis aséptica dentro de las 72 horas posteriores a la administración de OKT3.
- No se aislaron agentes infecciosos del líquido cefalorraquídeo.
- La meningitis aséptica se asoció fuertemente con el tratamiento OKT3.
- La vigilancia prospectiva identificó 3 casos (14%) de meningitis aséptica en 21 pacientes tratados con OKT3.
Conclusiones:
- La administración de OKT3 está fuertemente asociada con el desarrollo de meningitis aséptica en receptores de trasplante renal.
- El curso clínico de la meningitis aséptica asociada a OKT3 parece ser benigno y autolimitado.
- Se justifica la vigilancia continua de la terapia OKT3 para la meningitis.
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