Oral ulcers during the course of cytomegalovirus infection in renal transplant recipients

Transplant Proc. Jul-Aug 2009;41(6):2419-21. doi: 10.1016/j.transproceed.2009.06.053.

Abstract

Background: Cytomegalovirus (CMV) infection is frequent in kidney transplant recipients. Although involvement of the gastrointestinal tract with CMV has been described, intra-oral localization is rare. The aim of this study was to analyze the incidence, clinical characteristics, treatment, and outcome of renal transplant recipients with oral lesions due to CMV.

Patients and methods: We analyzed the records of 453 patients who underwent kidney transplantation between February 1989 and March 2007. Incident cases and characteristics of CMV oral lesions were ascertained retrospectively in the outpatient records.

Results: The cumulative incidence of 6 cases with oral ulcerations was 1.32%. The median follow-up (n = 453) was 61.84 +/- 50.68 months. The interval for the incidence of CMV oral ulcers after renal transplantation was 12.83 +/- 23.51 months. The affected oral locations included the buccal mucosa, hard palate, soft palate, tongue, and floor of the mouth. CMV cases showed no significant difference with regard to gender distribution, age at renal transplantation, renal transplant indication, type of immunosuppressive treatment, and donor/recipient CMV serological status before transplantation. The number of acute rejection episodes was significantly greater and time since transplantation was significantly shorter in CMV cases.

Conclusion: CMV infection, which is common in renal transplant recipients, only rarely affects the mouth. Herein we have reported 6 patients who suffered oral ulcers due to CMV infection. An early diagnosis of these lesions is important to a successful outcome for these patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cytomegalovirus Infections / epidemiology
  • Cytomegalovirus Infections / pathology*
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Kidney Diseases / surgery
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / immunology
  • Male
  • Middle Aged
  • Oral Ulcer / epidemiology
  • Oral Ulcer / virology*
  • Retrospective Studies

Substances

  • Immunosuppressive Agents