valganciclovir and Guillain-Barre-Syndrome

A 39-year-old male, who received a facial allograft (cytomegalovirus [CMV] donor-seropositive, recipient-seronegative), developed multidrug-resistant CMV infection despite valganciclovir prophylaxis (900 mg/day) 6 months post transplantation. Lower extremity weakness with upper and lower extremity paresthesias developed progressively 11 months post transplantation, coinciding with immune control of CMV. An axonal form of Guillain-Barré syndrome was diagnosed, based on electrophysiological evidence of a generalized, non-length-dependent, sensorimotor axonal polyneuropathy. Treatment with intravenous immunoglobulin led to complete recovery without recurrence after 6 months.

Topics: Adult; Antiviral Agents; Cytomegalovirus; Cytomegalovirus Infections; Drug Resistance, Multiple, Viral; Facial Transplantation; Ganciclovir; Guillain-Barre Syndrome; Humans; Immunocompromised Host; Immunoglobulins, Intravenous; Male; Time Factors; Valganciclovir; Viral Load; Viremia