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Article: Cytomegalovirus infection of the gastrointestinal tract in non-AIDS patients

TitleCytomegalovirus infection of the gastrointestinal tract in non-AIDS patients
Authors
Issue Date1993
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.html
Citation
American Journal Of Gastroenterology, 1993, v. 88 n. 11, p. 1882-1886 How to Cite?
AbstractCytomegalovirus infection is usually reported in immunocompromised patients. In this study, 19 patients with cytomegalovirus (CMV) infection of the alimentary tract were reviewed, none of whom had acquired immunodeficiency syndrome. The patients' sex distribution was similar, and their ages ranged from 22 to 84 yr (mean = 61 yr). Only four patients had underlying diseases resulting in immunocompromise. The most common presentation was gastrointestinal bleeding, which occurred in 11 of the 19 patients (58%). Two patients had an unusual presentation of obstructive jaundice due to exuberant growth of granulation tissue at the ampulla of Vater. The majority of the lesions (n = 23) occurred in the large intestine and duodenum. Sixteen of these 23 lesions (69.6%) showed ulceration. Of these 16 lesions, six were diagnosed macroscopically as malignant by the endoscopists. It was observed histologically that a predominant epithelial distribution of the CMV inclusion bodies was associated with no or only mild inflammation, whereas a predominant endothelial distribution of the inclusion bodies was associated with ulcerative, severely inflamed lesions. From these observations, we conclude that ulceration probably is due to an ischemic process resulting from narrowing of capillary lumens by swollen endothelial cells affected by CMV infection. Concomitant infection by Candida species was found in only one patient. One patient had coexistent ulcerative colitis while another also suffered from graft-versus-host disease after bone marrow transplantation. In five of the eight cases with follow-up biopsies, the CMV inclusion bodies disappeared in subsequent biopsies. To conclude, a high degree of alertness is required for the histological diagnosis of unexpected CMV infection of the alimentary tract, in order to warrant correct treatment for the patients.
Persistent Identifierhttp://hdl.handle.net/10722/147968
ISSN
2015 Impact Factor: 10.383
2015 SCImago Journal Rankings: 3.946
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorCheung, ANYen_US
dc.contributor.authorNg, IOLen_US
dc.date.accessioned2012-05-29T06:10:09Z-
dc.date.available2012-05-29T06:10:09Z-
dc.date.issued1993en_US
dc.identifier.citationAmerican Journal Of Gastroenterology, 1993, v. 88 n. 11, p. 1882-1886en_US
dc.identifier.issn0002-9270en_US
dc.identifier.urihttp://hdl.handle.net/10722/147968-
dc.description.abstractCytomegalovirus infection is usually reported in immunocompromised patients. In this study, 19 patients with cytomegalovirus (CMV) infection of the alimentary tract were reviewed, none of whom had acquired immunodeficiency syndrome. The patients' sex distribution was similar, and their ages ranged from 22 to 84 yr (mean = 61 yr). Only four patients had underlying diseases resulting in immunocompromise. The most common presentation was gastrointestinal bleeding, which occurred in 11 of the 19 patients (58%). Two patients had an unusual presentation of obstructive jaundice due to exuberant growth of granulation tissue at the ampulla of Vater. The majority of the lesions (n = 23) occurred in the large intestine and duodenum. Sixteen of these 23 lesions (69.6%) showed ulceration. Of these 16 lesions, six were diagnosed macroscopically as malignant by the endoscopists. It was observed histologically that a predominant epithelial distribution of the CMV inclusion bodies was associated with no or only mild inflammation, whereas a predominant endothelial distribution of the inclusion bodies was associated with ulcerative, severely inflamed lesions. From these observations, we conclude that ulceration probably is due to an ischemic process resulting from narrowing of capillary lumens by swollen endothelial cells affected by CMV infection. Concomitant infection by Candida species was found in only one patient. One patient had coexistent ulcerative colitis while another also suffered from graft-versus-host disease after bone marrow transplantation. In five of the eight cases with follow-up biopsies, the CMV inclusion bodies disappeared in subsequent biopsies. To conclude, a high degree of alertness is required for the histological diagnosis of unexpected CMV infection of the alimentary tract, in order to warrant correct treatment for the patients.en_US
dc.languageengen_US
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.htmlen_US
dc.relation.ispartofAmerican Journal of Gastroenterologyen_US
dc.subject.meshAcquired Immunodeficiency Syndromeen_US
dc.subject.meshBiopsyen_US
dc.subject.meshCholestasis - Etiologyen_US
dc.subject.meshCytomegalovirus Infections - Complications - Diagnosis - Epidemiologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshGastrointestinal Diseases - Diagnosis - Epidemiology - Microbiologyen_US
dc.subject.meshGastrointestinal Hemorrhage - Etiologyen_US
dc.subject.meshHong Kong - Epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshImmunocompromised Hosten_US
dc.subject.meshIncidenceen_US
dc.subject.meshIntestinal Mucosa - Pathologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.titleCytomegalovirus infection of the gastrointestinal tract in non-AIDS patientsen_US
dc.typeArticleen_US
dc.identifier.emailCheung, ANY:anycheun@hkucc.hku.hken_US
dc.identifier.emailNg, IOL:iolng@hkucc.hku.hken_US
dc.identifier.authorityCheung, ANY=rp00542en_US
dc.identifier.authorityNg, IOL=rp00335en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid8237936-
dc.identifier.scopuseid_2-s2.0-0027366351en_US
dc.identifier.volume88en_US
dc.identifier.issue11en_US
dc.identifier.spage1882en_US
dc.identifier.epage1886en_US
dc.identifier.isiWOS:A1993MF79700015-
dc.publisher.placeUnited Statesen_US

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