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CYP2C19*17 genetic polymorphism--an uncommon cause of voriconazole treatment failure. Diagn Microbiol Infect Dis 2015 Sep;83(1):46-8

Date

05/20/2015

Pubmed ID

25986028

DOI

10.1016/j.diagmicrobio.2015.05.002

Scopus ID

2-s2.0-84938739008 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

We describe an immunosuppressed, 48-year-old male, allogeneic hematopoietic stem cell transplant recipient with severe graft-versus-host disease who developed invasive pulmonary Aspergillus fumigatus infection 6 months after transplant. His lack of response to voriconazole and undetectable serum trough levels of the drug led us to establish that he had the uncommon cytochrome P450, CYP2C19*17 allele, which leads to a rapid metabolism of voriconazole but not of the other azole antifungals. We discuss the particular challenges encountered in this case.

Author List

Abidi MZ, D'Souza A, Kuppalli K, Ledeboer N, Hari P

Authors

Anita D'Souza MD Associate Professor in the Medicine department at Medical College of Wisconsin
Parameswaran Hari MD Adjunct Professor in the Medicine department at Medical College of Wisconsin
Nathan A. Ledeboer PhD Vice Chair, Professor in the Pathology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Antifungal Agents
Aspergillosis
Aspergillus fumigatus
Cytochrome P-450 CYP2C19
Humans
Immunocompromised Host
Inactivation, Metabolic
Male
Middle Aged
Polymorphism, Genetic
Stem Cell Transplantation
Transplantation, Homologous
Treatment Failure
Voriconazole