Tokunaga Nobuhiro, Sadahiro Sotaro, Kise Yoshifumi, Suzuki Toshiyuki, Mukai Masaya, Yasuda Seiei, Ogoshi Kyoji, Tajima Tomoo, Makuuchi Hiroyasu
Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
Tokai J Exp Clin Med. 2003 Apr;28(1):35-8.
Cytomegalovirus infection of the gastrointestinal tract is a rare serious complication in patients with collagen diseases receiving immunosuppressive agents. We report 3 such cases diagnosed by endoscopy followed by proper treatment. The patients include 38 and 53 years old females with systemic lupus erythematosus. They presented epigastric pain after pulse steroid therapy and combination therapy with steroids and cyclophosphamide, respectively. Their endoscopical findings were multiple small gastric erosions. The other patient was a 60-year-old female with polymyositis who developed rectal bleeding after steroid and imuran therapy. Her endoscopical finding was a discrete, irregular rectal ulcer. The diagnosis of all the patients was confirmed by biopsies of those lesions showing giant cell inclusion bodies and positive staining with anti- cytomegalovirus -antibodies. All patients were treated properly with ganciclovir. We should always keep in mind of a cytomegalovirus infection of the gastrointestinal tract in a patient with collagen disease receiving immunosuppressive agents.
巨细胞病毒感染胃肠道是接受免疫抑制剂治疗的胶原病患者中一种罕见的严重并发症。我们报告3例经内镜诊断并接受适当治疗的此类病例。患者包括两名患有系统性红斑狼疮的38岁和53岁女性，她们分别在接受脉冲类固醇治疗以及类固醇与环磷酰胺联合治疗后出现上腹部疼痛。她们的内镜检查结果均为多发性小的胃糜烂。另一名患者是一名60岁患有多发性肌炎的女性，在接受类固醇和硫唑嘌呤治疗后出现直肠出血。她的内镜检查结果是一个孤立的、不规则的直肠溃疡。所有患者病变活检显示巨细胞包涵体且抗巨细胞病毒抗体染色阳性，确诊为此病。所有患者均接受了更昔洛韦的适当治疗。对于接受免疫抑制剂治疗的胶原病患者，我们应始终牢记其胃肠道可能存在巨细胞病毒感染。
