Converting everolimus to mycophenolate mofetil ameliorated prolonged respiratory syncytial virus infection in a child after heart transplantation
Converting everolimus to mycophenolate mofetil ameliorated prolonged respiratory syncytial virus infection in a child after heart transplantation
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将依维莫司改为吗替麦考酚酯可改善心脏移植后儿童的长期呼吸道合胞病毒感染
DOI：
10.1136/bcr-2017-220342
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Kogaki Shigetoyo
中科院分区：
文献类型：
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作者：
Suginobe Hidehiro;Nawa Nobutoshi;Ishida Hidekazu;Kogaki Shigetoyo
在免疫功能低下的患者中，呼吸道合胞病毒(RSV)感染是已知的严重和持久的，并具有显著的死亡率和发病率。然而，目前对心脏移植受者RSV感染的临床病程和治疗策略知之甚少。在这里，我们报告一位6岁的女性心脏移植患者，她表现出长时间的呼吸道症状和呼吸道合胞病毒的脱落。她接受了伊波利莫作为免疫抑制剂的治疗。由于免疫抑制剂可能是导致呼吸道合胞病毒长期激活的原因，我们将依维莫司转换为霉酚酸酯。转换后，呼吸道合胞病毒迅速消失，她的症状有所改善。我们推测，由于不同的免疫抑制机制，转换免疫抑制剂可能对延长RSV感染有效。
In immunocompromised patients, respiratory syncytial virus (RSV) infections are known to be severe and prolonged, and have significant mortality and morbidity. However, little is known about the clinical courses and treatment strategy of RSV infection in heart transplant recipients. Here, we report a 6-year-old female with heart transplantation who had exhibited prolonged respiratory symptoms and shedding of RSV. She had received everolimus as an immunosuppressant. As immunosuppressants could have been responsible for the prolonged activation of RSV, we converted everolimus to mycophenolate mofetil. After the conversion, RSV promptly disappeared, and her symptoms improved. We speculate that converting the immunosuppressant may be effective for prolonged RSV infection due to the different immunosuppressive mechanisms.