Rezania Dorna, Ouban Abderrhman, Marcet Jorge, Kelley Scott, Coppola Domenico
Department of Pathology, University of South Florida, College of Medicine, FL, USA.
Am Surg. 2007 Jan;73(1):58-61.
The association between cytomegalovirus infection and inflammatory bowel disease challenges both the clinician and the pathologist to establish the correct diagnosis and to prescribe the most appropriate form of therapy. To understand this association the authors report three patients who presented with signs and symptoms mimicking reactivated inflammatory bowel disease who responded poorly to aggressive treatment of inflammatory bowel disease. Microscopic examination, in all three cases revealed numerous nuclear and cytoplasmic viral inclusions, as demonstrated by cytomegalovirus immunohistochemistry, as well as histologic findings consistent with inflammatory bowel disease (ulcerative colitis and/or Crohn's disease). Because the clinical pathologic features of cytomegalovirus colitis and inflammatory bowel disease often overlap, and because of the possible coexistence of cytomegalovirus colitis with idiopathic colitis, the possibility of cytomegalovirus infection should be always considered, so that the most appropriate therapy can be instituted for these patients.
巨细胞病毒感染与炎症性肠病之间的关联，对临床医生和病理学家在确立正确诊断及开具最合适治疗方案方面都构成了挑战。为了解这种关联，作者报告了三名患者，他们表现出类似炎症性肠病复发的体征和症状，对积极的炎症性肠病治疗反应不佳。在所有三例病例中，显微镜检查均发现大量核内和胞质内病毒包涵体，巨细胞病毒免疫组化证实了这一点，同时还有与炎症性肠病（溃疡性结肠炎和/或克罗恩病）相符的组织学表现。由于巨细胞病毒性结肠炎和炎症性肠病的临床病理特征常常重叠，且巨细胞病毒性结肠炎可能与特发性结肠炎并存，因此应始终考虑巨细胞病毒感染的可能性，以便为这些患者制定最合适的治疗方案。
