면역글로불린과 Leflunomide로 치료한 BK 바이러스 신병증 1예
A Case of Combining Intravenous Immunoglobulin and Leflunomide for BK Nephropathy
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초록
저자들은 면역억제제의 감량과 항바이러스제치료에도 진행하는 BK 바이러스 신병증을 면역글로불린으로 치료한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
BK virus nephropathy has emerged as an important cause of renal allograft dysfunction. It affects 1-10% of renal transplant patients and results in significant graft dysfunction in more than 50% of cases. A reduction in the amount of immunosuppressants is not an appropriate treatment option for advanced stage BK nephropathy; therefore, other treatment strategies need to be considered such as cidofovir, leflunomide, and intravenous immunoglobulin (IVIG) in combination with reduced immunosuppression. The use of IVIG may be a valuable treatment option in patients with BK virus nephropathy. We report our experience with IVIG rescue therapy in a patient and the progression of BK nephropathy despite leflunomide therapy. (Korean J Med 2011;81:512-516)
참고문헌 (13)
- 손영기, "신장이식 후 BK 바이러스 관련 신병증에서의 leflunomide의 임상경험", Kidney Research and Clinical Practice, 28(3), pp.211~218 (2009), 대한신장학회
- Brennan DC, "Incidence of BK with tacrolimus versus cyclosporine and impact of preemptive immunosuppression reduction", Am J Transplant, 5, pp.582~594 (2005)
- Randhawa P, "BK virus infection in transplant recipients: an overview and update", Am J Transplant, 6, pp.2000~2005 (2006)
- Binet I, "Polyomavirus disease under new immunosuppressive drugs: a cause of renal graft dysfunction and graft loss", Transplantation, 67, pp.918~922 (1999)
- Hirsch HH, "Polyomavirusassociated nephropathy in renal transplantation: interdisciplinary analyses and recommendations", Transplantation, 79, pp.1277~1286 (2005)
- Howell DN, "Diagnosis and management of BK polyomavirus interstitial nephritis in renal transplant recipients", Transplantation, 68, pp.1279~1288 (1999)
- Waldman WJ, "Inhibition of cytomegalovirus in vitro and in vivo by the experimental immunosuppressive agent leflunomide", Intervirology, 42, pp.412~418 (1999)
- Williams JW, "Leflunomide for polyomavirus type BK nephropathy", N Engl J Med, 352, pp.1157~1158 (2005)
- Faguer S, "Leflunomide treatment for polyomavirus BK-associated nephropathy after kidney transplantation", Transpl Int, 20, pp.962~969 (2007)
- Josephson MA, "Treatment of renal allograft polyoma BK virus infection with leflunomide", Transplantation, 81, pp.704~710 (2006)
- Leca N, "Higher levels of leflunomide are associated with hemolysis and are not superior to lower levels for BK virus clearance in renal transplant patients", Clin J Am Soc Nephrol, 3, pp.829~835 (2008)
- Lee JS, "Effect of high dose intravenous immunoglobulins on the treatment of antibody mediated humoral rejection and BK virus infection in renal transplant recipients", J Korean Soc Transplant, 21, pp.140~142 (2007)
- Sener A, "Intravenous immunoglobulin as a treatment for BK virus associated nephropathy: one-year follow-up of renal allograft recipients", Transplantation, 81, pp.117~120 (2006)