Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Am J Med Sci. 2018 Jun;355(6):607-609. doi: 10.1016/j.amjms.2017.11.012. Epub 2017 Nov 23.
Cytomegalovirus (CMV) infection is a common infectious complication in immunocompromised patients. The colon is the most common site of CMV infection in the gastrointestinal tract. Rarely, however, invasion of the upper gastrointestinal tract, such as the esophagus or stomach, has been reported. Herein, we describe the first reported case of CMV gastritis in a patient with end-stage renal disease and uremic symptoms (including nausea, vomiting, and poor appetite) who had begun hemodialysis therapy. This patient was not a transplant recipient and was not receiving immunosuppressant treatment. As CMV gastritis is easily over looked in patients with end-stage renal disease, physicians should maintain a high index of suspicion and establish the diagnosis as early as possible using an upper GI endoscopic biopsy and adequate staining.
巨细胞病毒(CMV)感染是免疫功能低下患者常见的感染性并发症。结肠是胃肠道中 CMV 感染最常见的部位。然而,上消化道(如食管或胃)的侵袭也很少见。在此,我们描述了首例报道的终末期肾病和尿毒症症状(包括恶心、呕吐和食欲不振)患者发生 CMV 胃炎的病例,该患者开始接受血液透析治疗。该患者不是移植受者,也未接受免疫抑制剂治疗。由于 CMV 胃炎在终末期肾病患者中很容易被忽视,因此医生应保持高度警惕,并通过上消化道内镜活检和充分染色尽早建立诊断。