Polprasert Chantana, Wongjitrat Chatchawan, Wisedopas Naruemon
Division of Hematology, Department of Medicine, Srinakarinwirot University, Faculty of Medicine, HRH Mahachakri Sirindhorn Medical Center, Bangkok, Thailand.
J Med Assoc Thai. 2011 Apr;94(4):498-500.
Cytomegalovirus (CMV) can infect immuno-compromised host, especially in HIV and bone marrow transplantation patients. CMV colitis was reported after receiving chemotherapy in a solid tumor and aggressive Non-Hodgkin's lymphoma, but not yet in indolent lymphoma patients.
In the present report, a 64-year-old woman was re-admitted with watery diarrhea after eight cycles of chemotherapy for Follicular lymphoma. She had hyponatremia, hypokalemia, and hypocalcemia, which were the consequences of severe diarrhea. After two weeks of continuous diarrhea, she was set for colonoscopy, which showed multiple ulcers along the colon. Pathological results were found to be consistent with CMV colitis. Her diarrhea symptom improved after receiving ganciclovir.
CMV colitis could occur in indolent lymphoma patients who receive R-CVP regimen (rituximab, cyclophosphamide, vincristine, and prednisolone). Patients exhibiting severe and prolonged diarrhea should be investigated for definite diagnosis in order to receive proper treatment.
巨细胞病毒（CMV）可感染免疫功能低下的宿主，尤其是艾滋病毒感染者和骨髓移植患者。在实体瘤及侵袭性非霍奇金淋巴瘤患者接受化疗后有巨细胞病毒性结肠炎的报道，但在惰性淋巴瘤患者中尚未见报道。
在本报告中，一名64岁女性在接受8个周期的滤泡性淋巴瘤化疗后因水样腹泻再次入院。她出现低钠血症、低钾血症和低钙血症，这些是严重腹泻的后果。持续腹泻两周后，她接受了结肠镜检查，结果显示结肠多处溃疡。病理结果发现与巨细胞病毒性结肠炎一致。接受更昔洛韦治疗后，她的腹泻症状有所改善。
接受R-CVP方案（利妥昔单抗、环磷酰胺、长春新碱和泼尼松龙）治疗的惰性淋巴瘤患者可能发生巨细胞病毒性结肠炎。对于出现严重且持续腹泻的患者，应进行检查以明确诊断，以便接受适当治疗。
