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Ganciclovir

Gancyclovir


Presentation

  • Pneumonitis is considered to be a rare manifestation although congenital CMV infection presents with various non-specific findings.[ncbi.nlm.nih.gov]
  • In the present report, we describe a case of ganciclovir treatment failure in a HSCT child who presented a refractory CMV infection despite harbouring a susceptible strain.[ncbi.nlm.nih.gov]
  • We present a case report of a cytomegalovirus (CMV)-seronegative, 58-year-old male who received a CMV-seropositive donor liver transplant without CMV prophylaxis.[ncbi.nlm.nih.gov]
  • METHODS: The present study focused on kidney transplant recipients with high quantities of CMV load after antiviral therapy. We collected 5 mL blood from each of 58 patients.[ncbi.nlm.nih.gov]
  • Hereby, we report a twelve-year-old boy who presented with tachycardia, tachypnea, fever and leukocytosis, which progressed to hypoxemic respiratory failure and severe acute respiratory distress syndrome (ARDS).[ncbi.nlm.nih.gov]
Anemia
  • Neutropenia and anemia were related to GCV overexposure. GCV-VCGV dose adjustment based on a population pharmacokinetics Bayesian prediction model optimizes GCV-VGCV exposure.[ncbi.nlm.nih.gov]
  • 10% Neutropenia w/ ANC Thrombocytopenia (20%) 1-10% Elevated LFTs Anemia Confusion Headache Nausea/vomiting Neuropathy Paresthesia Pruritus Retinal detachment, Rash Sepsis Weakness Frequency Not Defined Blood and lymphatic disorders: Pancytopenia, bone[reference.medscape.com]
  • Hematologic Toxicity: Granulocytopenia, anemia, thrombocytopenia, and pancytopenia have been reported in patients treated with Ganciclovir Injection. (5.1) Impairment of Fertility: Based on animal data, Ganciclovir Injection may cause temporary or permanent[sagentpharma.com]
  • This medicine may cause some serious side effects, including anemia and other blood problems. Before you begin treatment with ganciclovir, you and your doctor should talk about the good this medicine will do as well as the risks of using it.[mayoclinic.org]
Intravenous Administration
  • We treated an extremely premature female infant with postnatal cytomegalovirus infection with intravenous administration of ganciclovir since 49 days of life (postmenstrual age of 31 weeks).[ncbi.nlm.nih.gov]
  • Intravenous administration of ganciclovir (GCV) was initiated at 5 mg/kg every 12 h on day 18, and was continued until day 137. The amount of HHV-6 DNA in the plasma became undetectable on day 25.[ncbi.nlm.nih.gov]
  • Furthermore, immunohistochemical analysis showed that intravenous administration did not affect the expression of immune-associated TLR2 and TLR4.[ncbi.nlm.nih.gov]
  • Intravenous administration of ganciclovir is associated with transient mild-to-moderate elevations in serum ALT levels in 2% of patients. [5] These episodes have usually been asymptomatic and self-limited.[sjkdt.org]
  • For example, isolation of GanR CMV strains has been associated with clinical progression of CMV disease despite intravenous administration of full-dose ganciclovir [ 2–4 , 17 ].[academic.oup.com]
Liver Fibrosis
  • The changes of liver fibrosis, viral replication and liver function of both groups were compared for two weeks and six months.[ncbi.nlm.nih.gov]
Heart Block
  • However, our patient developed transient heart block as a rare complication for Ganciclovir therapy throughout his course.[ncbi.nlm.nih.gov]

Workup

Pericardial Effusion
  • Clinical manifestations depend on the extent and distribution of disease and, as in the majority of patients no detectable mass lesion is found, symptoms are related to fluid accumulation, dyspnoea (pleural or pericardial effusions), abdominal distension[ncbi.nlm.nih.gov]

Treatment

  • Treatment with double-dose ganciclovir and anti-CMV immunoglobulins did not decrease CMV viremia, so we diagnosed ganciclovir-resistant CMV infection. We decided to discontinue mycophenolic acid treatment and start leflunomide 20 mg BID.[ncbi.nlm.nih.gov]
  • In spite of close monitoring of her drug levels and increments of her treatment dose according to weight gain, she developed ganciclovir resistance after 4 months of treatment, with increasing viraemia and petechiae.[ncbi.nlm.nih.gov]
  • The viral load at the start of re-treatment was 6 million copies. In view of ganciclovir treatment failure, Sando immunoglobulins were administered.[ncbi.nlm.nih.gov]
  • […] as observation group, received combined treatment with ganciclovir and interferon.[ncbi.nlm.nih.gov]
  • Renal dysfunction occurred in 20 (51%) of 39 by end of treatment and in 7 (28%) of 25 after 6 months.[ncbi.nlm.nih.gov]

Prognosis

  • Nearly all glioblastomas (GBMs), brain tumours with very poor prognosis, are infected with human cytomegalovirus (CMV).[ncbi.nlm.nih.gov]
  • In addition, the prognosis for survival of AIDS patients being treated with ganciclovir is improved when compared with that of untreated patients.[ncbi.nlm.nih.gov]
  • Active intraocular CMV infection leads to severe retinal destruction and poor prognosis if left untreated.[bmcophthalmol.biomedcentral.com]
  • Conclusions The development of more effective antiviral treatments has dramatically improved the prognosis for patients with HSK; however, ocular HSV infection remains a major cause of corneal blindness and public health concern.[touchophthalmology.com]

Etiology

  • The response to antiviral therapy supports a viral etiology for chronic encephalitis of Rasmussen. If the disease is suspected, treatment with ganciclovir should be considered as early as possible.[neurology.org]
  • Laboratory testing can help to establish the etiology of atypical cases ( Chanzy 2002 ; Farhatullah 2004 ; Kowalski 1993 ).[doi.org]

Epidemiology

  • METHODS: We therefore analyzed CMV epidemiology in a large cohort of pediatric renal transplant recipients (n 242) and assessed the impact of antiviral chemoprophylaxis with valganciclovir (VGCV) or ganciclovir (GCV) on CMV replication and morbidity.[ncbi.nlm.nih.gov]
  • Herpes simplex virus epidemiology and ocular importance. Cornea 2001 Jan; 20(1): 1–13 PubMed CrossRef Google Scholar 2. Chaney SM, Warren KG, Kettyls J, et al.[dx.doi.org]
  • Mintz L, Drew WI, Miner RC, Braff EH Cytomegalovirus infections in homosexual men: an epidemiologic study. Annals of Internal Medicine 1983, 98: 326–329. Google Scholar 2.[link.springer.com]
  • On the basis of the epidemiology of GanR CMV in SOT recipients, it is likely that no single factor is likely to be responsible for the development of resistance.[academic.oup.com]
Sex distribution
Age distribution

Pathophysiology

  • This thoroughly updated Third Edition covers newly approved drugs, has separate chapters on drugs affecting fungal and viral infections, and includes more pathophysiology information.[books.google.ro]
  • Useful For Suggests clinical disorders or settings where the test may be helpful Monitoring patients on ganciclovir Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Ganciclovir[mayomedicallaboratories.com]
  • Pathophysiology of Herpes Simplex Virus Keratitis Ocular HSV infection comprises several potentially vision-impairing conditions.[touchophthalmology.com]

Prevention

  • Forman SJ, Zaia JA (1994) Treatment and prevention of cytomegalovirus pneumonia after bone marrow transplantation: where do we stand? Blood 83:2392–2398 PubMed Google Scholar 2.[dx.doi.org]
  • Prevention of cytomegalovirus (CMV) disease with ganciclovir has led to decrease morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients.[ncbi.nlm.nih.gov]
  • Similar dosing is used to prevent disease in high-risk patients, such as those infected with human immunodeficiency virus (HIV) or those with organ transplants.[en.wikipedia.org]
  • Different preventative strategies: Prophylaxis treats patients continuously with an antiviral from the day of engraftment to 100 days post-transplant in order to prevent recurrence or reactivation of CMV infection.[ti.ubc.ca]

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