LAUSR

Answers: 1. CMV viral load was evaluated considering the positivity of CMV IgG titer. Infectious work-up revealed the patient to have a CMVantigenemia with positive viral load by PCR (6640 copy/ml). 2. CMV infection in a patient with SLE. 3. Treatment with ganciclovir was started (5 mg/kg/day, intravenously for 2 weeks). Given the concurrent CMV viremia, additional immunosuppression was deferred until the CMV viral load was undetectable. The patient’s steroid dose was tapered, and mycophenolate mofetil was discontinued. CMV viral load peaked at a high 8040 copy/ml, but eventually converted to negative. After the first month of treatment, her laboratory examinations were as follows: hemoglobin 13.5 g/dl, WBC 11210/mm, platelet count 141,000/mm, AST 41 IU/ L, and ALT 90 IU/L. ANAwas positive at a titer of 1/320 with anti-ds DNA < 10 IU/mL, C3 90 mg/dL, and C4 10,2 mg/dL.