Yeh Pai-Jui, Chiu Cheng-Tang, Lai Ming-Wei, Wu Ren-Chin, Kuo Chia-Jung, Hsu Jun-Te, Su Ming-Yao, Le Puo-Hsien
Department of Pediatric Gastroenterology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.
Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, Taoyuan, Taiwan; Taiwan Association of the Study of Small Intestinal Disease, Taiwan.
Dig Liver Dis. 2021 Jun;53(6):722-728. doi: 10.1016/j.dld.2020.12.002. Epub 2021 Jan 11.
Cytomegalovirus (CMV) gastritis is occasionally reported in case reports and limited case series. Up to now, it is the largest and most comprehensive retrospective study of CMV gastritis.
All patients who were histologically diagnosed with CMV gastritis at Linkou Chang Gung Memorial Hospital between January 2000 and April 2020 were included. Patients were divided into two groups according to immunity. Between-group differences in characteristics, manifestations, endoscopic features, prognostic factors, and outcomes were analyzed. The main endpoint was 3-month mortality.
A total of 54 patients (34 immunocompromised, 20 immunocompetent) were enrolled. Common presentations included gastrointestinal bleeding (35.2%), abdominal pain (33.3%) and fever (31.5%). The endoscopic features included ulcer (88.9%) and inflammation (11.1%). The 3-month mortality rate was 20.4% and overall mortality rate was 40.7%. Acute kidney injury was the only independent risk factor for 3-month mortality (OR 53.89, 95%CI 1.56-1861.73, p = 0.027). Anti-viral therapy and host immune status did not affect 3-month mortality.
Both immunocompromised and immunocompetent patients with CMV gastritis have high mortality rates, without significant between-group differences. Acute kidney injury is the only independent predictive factor for 3-month mortality. Prevention of acute kidney injury may possibly improve the 3-month mortality rate.
巨细胞病毒（CMV）胃炎偶尔在病例报告和有限的病例系列中被报道。到目前为止，这是关于CMV胃炎最大且最全面的回顾性研究。
纳入2000年1月至2020年4月间在林口长庚纪念医院经组织学诊断为CMV胃炎的所有患者。根据免疫状态将患者分为两组。分析两组在特征、表现、内镜特征、预后因素和结局方面的差异。主要终点是3个月死亡率。
共纳入54例患者（34例免疫功能低下，20例免疫功能正常）。常见表现包括胃肠道出血（35.2%）、腹痛（33.3%）和发热（31.5%）。内镜特征包括溃疡（88.9%）和炎症（11.1%）。3个月死亡率为20.4%，总死亡率为40.7%。急性肾损伤是3个月死亡率的唯一独立危险因素（比值比53.89，95%置信区间1.56 - 1861.73，p = 0.027）。抗病毒治疗和宿主免疫状态不影响3个月死亡率。
免疫功能低下和免疫功能正常的CMV胃炎患者死亡率均较高，组间无显著差异。急性肾损伤是3个月死亡率的唯一独立预测因素。预防急性肾损伤可能会提高3个月死亡率。
