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Despite the greater risk of nephrotoxicity associated with the drug, a retrospective study observed a lower recurrence rate when compared with intravenous methylprednisolone, in addition to the shorter therapeutic course.79,80 Other described treatments include intravenous immunoglobulin, mepolizumab, dupilumab and plasmapheresis, whit success described in a few case reports.27 Specific antiviral treatment (e.g., ganciclovir) is a controversial subject, and although not recommended by some authors,75 if signs and symptoms are suggestive and there is confirmation of viral reactivation, specific immunoglobulins and antivirals should be tried

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[ Shows her forearm .] I was twenty-two

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