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Case Reports in Transplantation
Volume 2012 (2012), Article ID 465089, 4 pages
http://dx.doi.org/10.1155/2012/465089
Case Report

Fatal CMV-Infection after Autologous Stem Cell Transplantation in Refractory Systemic Lupus Erythematosus

13rd Department of Medicine, Institute for Medicine, Medical and Health Science Center, University of Debrecen, Móricz Zs. krt. 22, Debrecen 4032, Hungary
2Division of Clinical Immunology and Rheumatology, National Institute for Rheumatology and Physiotherapy, Frankel Leó Strasse 25-29, Budapest H-1023, Hungary

Received 20 November 2011; Accepted 26 January 2012

Academic Editor: C. Costa

Copyright © 2012 László Váróczy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

High-dose chemotherapy followed by autologous stem cell transplantation can be a rescue for patients with severe refractory systemic lupus erythematosus (SLE). However, the procedure might have fatal complications including infections and bleeding. We report on a young female patient with SLE whose disease started in her early childhood. After many years, severe renal, neurological, and bone marrow involvement developed that did not respond to conventional therapy. She was selected for autologous stem cell transplantation. A successful peripheral stem cell apheresis was performed in March 2006. The nonselected graft was reinfused in August 2006 after a conditioning chemotherapy containing high-dose cyclophosphamide and antithymocyte globulin. Engraftment was detected within 11 days. On the 38th posttransplant day, severe cytomegalovirus (CMV) infection developed that included pneumonitis, hepatitis, and pancytopenia. The patient died in a week due to multiorgan failure. With her case, we want to call the attention to this rare, but lethal complication of the autologous transplantation.