Case ReportBilateral Cytomegalovirus Retinitis in a Patient With Systemic Lupus Erythematosus and End-Stage Renal Disease
Section snippets
Report of A Case
In May 2000, a 37-year-old woman was seen in our eye clinic for evaluation of floaters noted in her right eye for the preceding 2 weeks. She had no other symptoms, and a review of systems yielded normal findings. Her history was remarkable for SLE diagnosed 17 years previously in Jamaica. In 1993, a renal biopsy performed at another US hospital revealed diffuse proliferative glomerulonephritis. The patient received 10 cycles of intravenous bolus cyclophosphamide and was lost to medical
Discussion
Smith7 first described CMV retinitis in 1964 as an opportunistic infection of the neural retina that occurs in patients whose immune system is suppressed. Cytomegalovirus retinitis has been reported in patients receiving immunosuppressive medications after renal or heart transplantation, in patients who are immunocompromised due to leukemia and lymphoma, and in patients with acquired immunodeficiency syndrome.1, 2, 3, 4 To our knowledge, an association between SLE and CMV retinitis in the
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Cited by (25)
Eye disease in kidney transplantation: Clinical challenges in a unique patient population
2022, Survey of OphthalmologyCitation Excerpt :Finally, immunomodulation needed to treat SLE (or other autoimmune conditions) may carry its own ocular implications similarly to KT recipients. Cytomegalovirus (CMV) retinitis has indeed been reported in an individual with lupus nephritis on oral immunosuppression.165 While no dedicated registry of ocular manifestations post-KT in SLE has been reported to date, a case series of KT recipients afflicted with antiphospholipid syndrome post-transplantation found optic ischemia in 7 of 96 patients.177
Management of infection in systemic lupus erythematosus
2013, Best Practice and Research: Clinical RheumatologyCitation Excerpt :Notably, CMV infection can be considered as an opportunistic infection, when affecting SLE patients on chronic steroids and/or immunosuppressive agents. Among the possible CMV-related manifestations, retinitis has to be kept in mind, especially when ongoing therapy includes both azathioprine and low-dose corticosteroid [43]. Interestingly, SLE has a lower incidence in the human immunodeficiency virus (HIV)-infected population when compared to the general population [44].
Intravitreal ganciclovir in the management of non-AIDS-related human cytomegalovirus retinitis
2010, Canadian Journal of OphthalmologyCMV retinitis in patients on mycophenolate immunosuppression: a report of two cases
2023, Allergy, Asthma and Clinical ImmunologyCytomegalovirus-associated nephrotic syndrome in a patient with myasthenia gravis treated with azathioprine: A case report
2021, American Journal of Case Reports
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Dr Choksi is now with Winthrop University Hospital, Mineola, NY.