TY - JOUR
T1 - Clinical and endoscopic features for alimentary tract cytomegalovirus disease
T2 - Report of 20 cases with gastrointestinal cytomegalovirus disease
AU - Lin, Wey Ran
AU - Su, Ming Yao
AU - Hsu, Chen Ming
AU - Ho, Yu Pin
AU - Ngan, Kah Wai
AU - Chiu, Cheng Tang
AU - Chen, Pang Chi
PY - 2005/7
Y1 - 2005/7
N2 - Background: The clinical presentations and endoscopic features of cytomegalovirus (CMV) infection in the gastrointestinal (GI) tract are diverse, and can mimic other inflammatory gastrointestinal diseases. Methods: From 1987 to 2003 at Chang-Gung Medical Center, 20 patients with CMV infections of the GI tract who were assessed using endoscopic examinations and diagnosed via pathologic studies were retrospectively reviewed. Results: Most of the patients were adults with immunocompromised conditions (10/20). GI tract bleeding was the most common clinical manifestation (11/20). Five patients presented with abdominal pain, and two patients presented with diarrhea. Fifteen patients suffered from fever. The endoscopic abnormalities could be classified into four main groups: inflammatory mucosa alone (3/20), ulceration alone (7/20), inflammatory mucosa associated with ulcer (9/20) and sub-mucosal tumor with ulcer (1/20). Of the 17 patients with ulcer lesions, ten had multiple ulcers and 12 had large ulcers exceeding 2 centimeters in diameter. Of the six patients followed up with colonoscopy, one was free of disease, one had a single ulcer, and four had colitis and were CMV positive on repeat biopsy. Two patients had colon strictures with persistent CMV colitis. Conclusion: Many patients with GI tract CMV infection are immunocompromised. Gastrointestinal bleeding is the most common initial presentation of gastrointestinal CMV disease. Fever is the most common associated toxic sign. Sigmoidoscopy cannot replace colonoscopy for detecting CMV colitis. The most common feature is multiple ulcers with at least one large ulcer. Endoscopic follow-up in patients with CMV colitis is recommended to investigate for possible persistent colitis and strictures.
AB - Background: The clinical presentations and endoscopic features of cytomegalovirus (CMV) infection in the gastrointestinal (GI) tract are diverse, and can mimic other inflammatory gastrointestinal diseases. Methods: From 1987 to 2003 at Chang-Gung Medical Center, 20 patients with CMV infections of the GI tract who were assessed using endoscopic examinations and diagnosed via pathologic studies were retrospectively reviewed. Results: Most of the patients were adults with immunocompromised conditions (10/20). GI tract bleeding was the most common clinical manifestation (11/20). Five patients presented with abdominal pain, and two patients presented with diarrhea. Fifteen patients suffered from fever. The endoscopic abnormalities could be classified into four main groups: inflammatory mucosa alone (3/20), ulceration alone (7/20), inflammatory mucosa associated with ulcer (9/20) and sub-mucosal tumor with ulcer (1/20). Of the 17 patients with ulcer lesions, ten had multiple ulcers and 12 had large ulcers exceeding 2 centimeters in diameter. Of the six patients followed up with colonoscopy, one was free of disease, one had a single ulcer, and four had colitis and were CMV positive on repeat biopsy. Two patients had colon strictures with persistent CMV colitis. Conclusion: Many patients with GI tract CMV infection are immunocompromised. Gastrointestinal bleeding is the most common initial presentation of gastrointestinal CMV disease. Fever is the most common associated toxic sign. Sigmoidoscopy cannot replace colonoscopy for detecting CMV colitis. The most common feature is multiple ulcers with at least one large ulcer. Endoscopic follow-up in patients with CMV colitis is recommended to investigate for possible persistent colitis and strictures.
KW - Colonic stricture
KW - Cytomegalovirus (CMV)
KW - Gastrointestinal (GI) tract
KW - Ulcer
UR - http://www.scopus.com/inward/record.url?scp=24644518479&partnerID=8YFLogxK
M3 - 文献综述
C2 - 16231531
AN - SCOPUS:24644518479
SN - 0255-8270
VL - 28
SP - 476
EP - 484
JO - Chang Gung Medical Journal
JF - Chang Gung Medical Journal
IS - 7
ER -