Hina Abbas, Mohammad Hanif Mengal, Kiran Aamir, Khalid Zafar Hashmi.
Frequency of Thrombocytopenia and Leucopenia in Renal Transplant Recipients Taking Anti CMV Therapy.
J Saidu Med Col Jan ;8(2):143-7.

Background: Cyto Megalo Virus (CMV) is among most frequently reported opportunistic infection causing morbidity and mortality in solid organ transplant recipients. Intravenous Ganciclovir is the recommended first line treatment strategy. Hematological complications have been reported as an important adverse effect of Ganciclovir therapy and therefore limits its optimal therapy. This study will provide data about the frequency of hematological adverse effects of anti CMV therapy in renal transplant recipients. Objective: To determine the frequency of thrombocytopenia and leucopenia in renal transplant recipients taking anti CMV therapy Materials & Methods: This was a cross sectional descriptive study and it was conducted at Department of Hematology at Sindh st st Institute of Urology And Transplantation (SIUT), Karachi for a period of 6 months i.e. from 1 November 2012 to 31 may 2013. Hundred 100 renal transplant recipients who were diagnosed as CMV positive on serological testing and taking Ganciclovir therapy, admitted in transplant ICU at SIUT were enrolled for the study after Informed consent. Patients with diagnosed hematological problem or having thrombocytopenia and leucopenia before taking Ganciclovir therapy were excluded. A structured Performa was used to collect data. Data was recorded including clinical history, age, gender and complete blood counts (CBC).Frequency of thrombocytopenia and leucopenia age and sex distribution were recorded. Results: CBC parameters of all CMV positive renal transplant recipients taking Ganciclovir therapy were recorded before and after starting Ganciclovir therapy. Out of these 100 cases 43(43%) patients developed complications of anti CMV therapy. Thrombocytopenia developed in 24(24%). leucopenia developed in 31 (31%) patients of which 11% had leucopenia without neutropenia while 20% cases had leucopenia with neutropenia. Eleven 12 (12%) patients developed thrombocytopenia and leucopenia both as a complication of anti CMV therapy. Conclusion: All the cases of hematological complications were diagnosed by simple laboratory methods .Of the 100 CMV positive patients taking Ganciclovir therapy 43 (43%) patients suffered complications (Thrombocytopenia and leucopenia) of anti CMV Therapy. More prolonged and follow-up studies are needed to define the true significance of these complications in post-transplant settings.

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