Clinical Endoscopy

Ménétrier’s Disease as a Gastrointestinal Manifestation of Active Cytomegalovirus Infection in a 22-Month-Old Boy: A Case Report with a Review of the Literature of Korean Pediatric Cases: Jeana Hong, Seungkoo Lee, Yoonjung Shon; Clin Endosc 2018;51(1):89-94. Published online June 13, 2017; DOI: https://doi.org/10.5946/ce.2017.038

Ménétrier’s disease (MD), which is characterized by hypertrophic gastric folds and foveolar cell hyperplasia, is the most common gastrointestinal (GI) cause of protein-losing enteropathy (PLE). The clinical course of MD in childhood differs from that in adults and has often been reported to be associated with cytomegalovirus (CMV) infection. We present a case of a previously healthy 22-month-old boy presenting with PLE, who was initially suspected to have an eosinophilic GI disorder (EGID). However, he was eventually confirmed, by detection of CMV DNA using polymerase chain reaction (PCR) with gastric tissue, to have MD associated with an active CMV infection. We suggest that endoscopic and pathological evaluation is necessary for the differential diagnosis of MD. In addition, CMV DNA detection using PCR analysis of biopsy tissue is recommended to confirm the etiologic agent of MD regardless of the patient’s age or immune status.

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Clinical Manifestation of Cytomegalovirus-Associated Protein-Losing Enteropathy in Children
Claire Ferrua, Anais Lemoine, Alexis Mosca, Anne-Aurélie Lopes
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Menetrier disease and Cytomegalovirus infection in paediatric age: report of three cases and a review of the literature
Federica Barbati, Edoardo Marrani, Giuseppe Indolfi, Paolo Lionetti, Sandra Trapani
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Jasmina Krikilion, Elvira Ingrid Levy, Yvan Vandenplas
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Hou-Hong Wang, Can-Can Zhao, Xiao-Lei Wang, Ze-Nong Cheng, Zong-Yu Xie
World Journal of Clinical Cases.2021; 9(23): 6943. CrossRef
Ménétrier’s disease in a patient with refractory ulcerative colitis: a clinical challenge and review of the literature
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BMJ Case Reports.2021; 14(10): e246137. CrossRef

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CMV Gastric Ulcers Healed by Supportive Therapy: Hyoung Don Lee, M.D., Nam-Hoon Kim, M.D., Ki Jun Lee, M.D., Hyuk Lee, M.D., Jin Ho Jun, M.D., Won Ki Bae, M.D., Kyung-Ah Kim, M.D. and June Sung Lee, M.D.; Korean J Gastrointest Endosc 2011;43(1):21-24. Published online July 28, 2011

Abstract PDF: Cytomegalovirus (CMV) is a potentially important pathogen in an immunocompromised host. CMV infection usually occurs in patients with severe immune deficiency, such as acquired immunodeficiency syndrome, organ transplantation, malignant disease, or immunosuppressive therapy. CMV can cause ulcerations anywhere in the GI tract ranging from the esophagus to the rectum, but the colon is the most susceptible organ in the GI tract. CMV infection rarely occurs but generally causes an asymptomatic or mildly symptomatic acute illness in immunocompetent patients. Some patients with gastrointestinal CMV disease do not require antiviral treatment such as ganciclovir and frequently recover with supportive therapy. Although in immunocompetent patients, antiviral therapy may be needed based on age, chronic illness, or treatment response. We experienced a case of CMV-induced multiple gastric ulcers with severe epigastric pain in an immunocompetent patient who fully recovered with supportive therapy including a proton pump inhibitor. (Korean J Gastrointest Endosc 2011;43:21-24)

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Cytomegalovirus Infectious Mononucleosis in a Patient with a Gastric Ulcer: Se Yoon Park, M.D., Eun Jung Lee, M.D., Tae Hee Lee, M.D., So My Koo, M.D., Jin Nyoung Kim, M.D., Min Huok Jeon, M.D., Eun Ju Choo, M.D. and Tae Hyong Kim, M.D.; Korean J Gastrointest Endosc 2011;42(6):392-396. Published online June 4, 2011

Abstract PDF: Cytomegalovirus (CMV) is a prevalent pathogen, with 98∼100% of Korean adults showing prior exposure by serology. A primary infection, such as CMV infectious mononucleosis, is very rare. CMV infectious mononucleosis often presents an initial diagnostic problem. Patients are often hospitalized with a wide variety of clinical diagnoses including fever of unknown origin without pharyngitis and lymphadenopathy. CMV gastrointestinal infections are rare in previously immunocompetent individuals. The most common sites involved are the colon and rectum, although lesions of the stomach have also been described. It is unusual to see CMV infectious mononucleosis and CMV gastrointestinal infection in the same patient. Our patient received symptomatic treatment and fully recovered. We present a case of CMV infectious mononucleosis with gastric ulcers in a previously healthy adult.

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Cytomegalovirus Colitis Causing Cecal Perforation and Massive Lower Gastrointestinal Bleeding: Jung Won Jeon, M.D., Jae Myung Cha, M.D., Joung Il Lee, M.D., Kwang Ro Joo, M.D., Hyun Phil Shin, M.D., Jae Jun Park, M.D., Kwan Mi Pack, M.D. and Jun Uk Lim, M.D.; Korean J Gastrointest Endosc 2011;42(1):33-37. Published online January 30, 2011

Abstract PDF: Cytomegalovirus (CMV) infection is associated with significant morbidity and mortality in immunocompromised patients. It may cause serious illness including bleeding, ulceration and perforation of the gastrointestinal tract. However, bowel perforation, toxic megacolon, and massive lower gastrointestinal bleeding caused by CMV in one patient is not common. In this report, we present a case of CMV colitis causing cecal perforation and massive lower gastrointestinal bleeding in a patient with lupus nephritis. In our case, severe lower gastrointestinal bleeding developed during successful treatment of CMV infection with ganciclovir. Even though the outcome of CMV colitis has improved since ganciclovir has been available for immunocompromised patients, reductions in gastrointestinal bleeding from colonic ulcers of CMV colitis may be possible during successful treatment with ganciclovir. This case suggests the possibility of lower gastrointestinal bleeding from a colon ulcer of CMV colitis should be considered during successful treatment with ganciclovir in immunocompromised patients. (Korean J Gastrointest Endosc 2011;42:33-37)

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Cytomegalovirus Colitis with Ulcerative Colitis in the Steroid Naïve Immunocompetent Patient: Hyo Keun Lee, M.D., Won Ki Bae, M.D., Woo Sun Rou, M.D., Tae Jun Song, M.D., Nam-Hoon Kim, M.D., Kyung-Ah Kim, M.D., June Sung Lee, M.D. and Mee Joo, M.D.*; Korean J Gastrointest Endosc 2010;41(6):385-389. Published online December 30, 2010

Abstract PDF: Ulcerative colitis is an idiopathic chronic inflammatory bowel disease that exclusively involves the colon. It is characterized by diffuse mucosal inflammation and a recurrent course of remission and relapse. Factors such as smoking, diet, genetic factors and miocrobial infection have all been suggested as causes of ulcerative colitis. One of the important issues in the treatment of ulcerative colitis is opportunistic infection associated with the usage of corticosteroid and immunosuppresant. In most cases, opportunistic cytomegalovirus infection after treatment with corticosteroid or immunosuppressant worsens the course of ulcerative colitis. However, cytomegalovirus infection is uncommon in immunocompetent patients and it is rare in immunocompetent patients with corticosteroid naive ulcerative colitis. We report here on a case in which an immunocompetent patient was newly diagnosed with ulcerative colitis and cytomegalovirus coinfection simultaneously. (Korean J Gastrointest Endosc 2010;41:385-389)

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A Case of a Cytomegalovirus Colitis Related Rectal Stricture Treated by Endoscopic Balloon Dilation: Kwonoh Park, M.D., Kyung Ho Kim, M.D., Jong Won Park, M.D., Sangho Lee, M.D., Hyunjung Jo, M.D., Seungyun Chun, M.D., Hyewon Park, M.D. and Hak Yang Kim, M.D.; Korean J Gastrointest Endosc 2010;41(4):240-244. Published online October 30, 2010

Abstract PDF: Cytomegalovirus (CMV) colitis is a common opportunistic infection in immunocompromised patients. Affected individuals present with abdominal pain, diarrhea, or hematochezia. Complications of CMV colitis can include massive bleeding, toxic megacolon, bowel perforation and, rarely, colon stricture. A 69-year-old woman who had no specific past history was admitted to the orthopedic department for pelvic bone fracture with right iliac artery rupture caused by a traffic accident. She was successfully managed with emergency transarterial coil embolization. After 2 weeks, she developed hematochezia and recurrent abdominal pain. Colonoscopy showed a huge, deep ulcer in the rectosigmoid colon. Biopsy and immunohistochemical staining revealed giant cells with intracellular inclusion bodies that were positive for CMV antigen. She received antiviral treatment after which her symptoms improved. On follow-up colonoscopy 3 months later, we found a tight luminal narrowing in the rectum. We did a repeat endoscopic balloon dilation in this patient and she experienced improvement. (Korean J Gastrointest Endosc 2010;41:240-244)

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A Case of Cytomegalovirus-Associated Esophageal and Duodenal Ulcers in a Critically Ill Immunocompetent Patient: Su-Yeon Lee, M.D., You Sun Kim, M.D., Jin-Ho Lee, M.D., Jong Hyeok Park, M.D., Sang-Ryul Lee, M.D., Soo-Hyung Ryu, M.D., Jung Hwan Lee, M.D. and Jeong Seop Moon, M.D.; Korean J Gastrointest Endosc 2009;39(4):217-221. Published online October 30, 2009

Abstract PDF: Cytomegalovirus (CMV) infection usually occurs in immunocompromised individuals such as patients who receive chemotherapy, glucocorticoid therapy, and patients infected with human immunodeficiency virus (HIV). CMV infection can also occur in immunocompetent adults, but active infection is apparently rare. CMV infection can present anywhere in the gastrointestinal tract, most commonly in the colon and rarely in the small intestine. Simultaneous CMV infection in the stomach, small bowel and colon of immunocompetent adults has rarely been reported. We report a case of cytomegalovirus-associated esophageal and duodenal ulcers in an immunocompetent adult where the patient had undergone a neurosurgical operation. (Korean J Gastrointest Endosc 2009;39:217-221)

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Cytomegalovirus Colitis in an Immunocompetent Patient with Henoch-SchoҨnlein Purpura: Jung Yoon Yoon, M.D., Sung-Ae Jung, M.D., Hyun Joo Song, M.D., Min-Jung Kang, M.D., Seong-Eun Kim, M.D., Ki-Nam Shim, M.D., Kwon Yoo, M.D. and Dong Eun Song, M.D.*; Korean J Gastrointest Endosc 2009;39(3):176-180. Published online September 30, 2009

Abstract PDF: Most cases of cytomegalovirus (CMV) colitis occur in adults with severe immuno- deficiency. There have been a few reports involving immunocompetent patients. CMV colitis may occur after colonic mucosal injury in immunocompetent patients. Henoch-SchoҨnlein purpura (HSP) is a common systemic vasculitis in childhood. Diagnostic criteria include palpable purpura with at least one other manifestation; abdominal pain, IgA deposition, arthritis or arthralgia, or renal involvement. To best of our knowledge, we describe the first case of CMV colitis in an immunocompetent patient with preceding HSP. A 38-year-old man presented with a 1-day history of abdominal pain, diarrhea and vomiting. Two-years previously, he underwent a right hemicolectomy due to intussusception. Over a 1-month period, palpable purpura was evident on both arms and legs. Colonoscopy revealed multiple, linear geographic ulcerations at an anastomosis opening site with huge ulceration at the small bowel, which was covered with white exudates. Colonoscopic biopsy showed CMV inclusion bodies and skin biopsy revealed leukocytoclastic vasculitis. The patient was successfully treated with gancyclovir and prednisolone. (Korean J Gastrointest Endosc 2009;39:176-180)

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A Case of Cytomegalovirus and Pseudomembranous Colitis in an Immunocompetent Adult: Seong Yeol Ryu, M.D., Kwi Hyun Bae, M.D. and Byoung Kuk Jang, M.D.; Korean J Gastrointest Endosc 2009;38(5):279-283. Published online May 30, 2009

Abstract PDF: Cytomegalovirus (CMV) colitis is a rare event that has been described mainly in immunocompromised patients who are on immunosuppressive medication or they have HIV infection. CMV colitis manifesting in an immunocompetent host is exceedingly rare, but this has occasionally been described in pregnant patients and patients with chronic renal failure. Pseudomembranous colitis (PMC) is known to develop with long-term antibiotic administration and it is caused by the abnormal overgrowth of toxin-producing Clostridium difficile that colonize the large bowel. Appropriate diagnostic testing and early treatment may avert morbidity and mortality. A case of the simultaneous occurrence of cytomegalovirus and Clostridium difficile colitis in an immunocompetent adult has not yet been reported in the Koran medical literature. We report here on a case of the simultaneous occurrence of cytomegalovirus and Clostridium diffiicle colitis in an immunocompetent Korean adult. (Korean J Gastrointest Endosc 2009;38:279-283) Key Words:

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Spontaneous Resolving of Cytomegalovirus Associated Gastritis after Conservative Treatment in Immunocompetent Patients: A Report of Two Cases: Jaehoon Lee, M.D., Suck Chei Choi, M.D., Chang Soo Choi, M.D. and Tae Hyeon Kim, M.D.; Korean J Gastrointest Endosc 2008;37(5):344-348. Published online November 30, 2008

Abstract PDF: Cytomegalovirus (CMV) disease is an important cause of morbidity and mortality in an immunocompromised host. Patients with AIDS, organ transplantion and chemotherapy for malignant disease are susceptible to CMV diseases. CMV disease rarely occurs in an immunocompetent host. The gastrointestinal tract is one of target organs for CMV infection. Immunocompetent patients with gastrointestinal CMV disease frequently recover with supportive therapy. If immunosuppressive therapy is stopped, patients infected with CMV can be spontaneously cured. However, as the prognosis of CMV infection in immunocompromised patients is usually poor, the administration of an antiviral agent is recommended for treatment. We report two cases of gastric CMV in immonocompetent patients who completely recovered with supportive treatment without antiviral therapy. (Korean J Gastrointest Endosc 2008;37:344-348)

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Acute Cytomegalovirus Proctocolitis Presenting with Massive Lower Gastrointestinal Bleeding: Su Yeon Rhie, M.D., Chang Hwan Choi, M.D., Hyun Woong Lee, M.D., Mi Young Do, M.D., Seong Hyun Lee, M.D., Chae Heo, M.D., Suk Won Kim, M.D., Hyung Joon Kim, M.D., Sae Kyung Chang, M.D., Tae Jin Lee, M.D.* and Hwa Eun Oh, M.D.^†; Korean J Gastrointest Endosc 2007;35(2):110-115. Published online August 30, 2007

Abstract PDF: Cytomegalovirus (CMV) colitis usually affects immunosuppressed patients. However, CMV colitis may also affect patients with a debilitation caused by a severe illness or affect patients that have a specific physiological status (old age, pregnancy). Clinically, patients with CMV colitis most commonly present with abdominal pain, diarrhea, and gastrointestinal bleeding. The diagnosis of CMV colitis usually requires a biopsy of mucosal tissue. The characteristic finding on biopsy reveals CMV inclusion bodies. CMV colitis can be successfully treated with ganciclovir. We report two cases of CMV proctocolitis in elderly patients with chronic diseases that presented with massive lower gastrointestinal bleeding due to multiple rectal ulcerations. A pathological examination showed CMV inclusion bodies. CMV colitis should be considered in the differential diagnosis of patients with massive rectal ulcer bleeding when other causes fail to explain the course of the disease.

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A Case of Cytomegalovirus Infection associated with Simultaneous Gastric, Duodenal and Colonic Ulcers: Jae Ho Lee, M.D., Eun Taek Park, M.D., Hee Kim, M.D., Sang Bong Lee, M.D., Sung Jae Park, M.D., Sam Ryoung Jee, M.D., Yeon Jae Lee, M.D., Sang Hyuk Lee, M.D., Sang Young Seol, M.D., Jung Myung Chung, M.D. and Soo Jin Jung, M.D.*; Korean J Gastrointest Endosc 2006;32(1):42-47. Published online January 30, 2006

Abstract PDF: Although cytomegalovirus (CMV) infection of the gastrointestinal tract can occur in persons with normal immune function, it almost exclusively affects the immunocompromised host such as transplant recipients and AIDS patients, and it can cause significant clinical illness. CMV remains the single most important pathogen that affects solid organ transplant recipients. While CMV can affect any segment of the gastrointestinal tract, the colon is the most common site of infection, and this is followed by the upper gastrointestinal tract. However, CMV infection associated with simultaneous gastric and colonic ulcer is very rare and this has been reported in only one case, and a case of simultaneous gastric, duodenal and colonic ulcer associated with CMV infection has not yet been reported in Korea. We report here on a case of simultaneous gastric, duodenal and colonic ulcer associated with CMV infection that showed the characteristic histologic findings seen for CMV infection in renal transplant recipients. (Korean J Gastrointest Endosc 2006; 32:42⁣47)

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Ileal Perforation due to Cytomegalovirus Enteritis in a Patient with Acquired Immune Deficiency Syndrome: Yeon Soo Kim, M.D., Won Seok Heo, M.D., Kyung Hoon Chae, M.D., Youn Se Gang, M.D., Jae Hoon Jung, M.D., Ki O Park, M.D., Jae Kyu Seong, M.D., Yeon Sook Kim, M.D., Hyun Yong Jeong, M.D. and Geu Sang Song, M.D.*; Korean J Gastrointest Endosc 2005;30(4):217-221. Published online April 30, 2005

Abstract PDF: Cytomegalovirus (CMV) infection is one of important opportunistic infections and cause significant morbidity and mortality in immunocompromised patients. The colon, stomach, and esophagus are the organs frequently involved with CMV infection. CMV enteritis makes up less than 10% of the CMV gastroenteritis cases, usually presents with diarrhea, bleeding and perforation. Several reports have described patients with acquired immune deficiency syndrome (AIDS) in whom CMV enterocolitis were complicated by ileal perforation, but have been rarely reported in Korea. We report a case of multiple ileal perforation associated with CMV enteritis in 67 years old man who was diagnosed as AIDS later. He complained of hematochezia and abdominal pain. During emergency operation, multiple perforated lesions were seen at the distal ileum above ileocecal valve. Colonoscopic examination revealed multiple shallow aphthoid ulcers at descending colon. CMV enteritis and colitis were diagnosed by microscopic findings of both surgical and endoscopic specimens. He was recovered by antiviral therapy with ganciclovir. (Korean J Gastrointest Endosc 2005;30:217⁣221)

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A Case of Cytomegalovirus Gastric Ulcer Mimicking Gastric Cancer in an: Lae Hyun Phyun, M.D., Kwang Hyun Ko, M.D., Esther Kim, M.D., Sun Young Kwak, M.D.,; Korean J Gastrointest Endosc 2004;28(2):92-96. Published online March 1, 2004

Abstract PDF: A 27-year-old woman presented with epigastric pain. Abdominal computed tomography revealed an irregular ulcer with circumferential thickening of the gastric antral wall. An endoscopy suggested advanced gastric cancer or gastric lymphoma. Biopsy of the lesion showed an inclusion body of the cytomegalovirus and positive immunohistochemical staining of the infected cell for cytomegalovirus. A thorough evaluation of her immune system revealed no abnormality. General supportive treatment for gastric ulcer did not relieve her symptoms. Intravenous infusion of ganciclovir improved her symptoms and healed the ulcer. We report a case of cytomegalovirus-associated gastric ulcer mimicking malignancy in an immunocompetent woman. (Korean J Gastrointest Endosc 2004;28: 92⁣96)

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A Case of Cytomegalovirus (CMV) Colitis in a Patient after Splenectomy: Sang Yol Chon, M.D., Yun Jeong Lim, M.D., Mi Young Kim, M.D*., Jung Rye Kim, M.D^†., Dong Hyun Lee, M.D., Ju Rak Ma, M.D., Ga Young Lee, M.D., Choon Kwan Kim, M.D., Su Hyun Yang, M.D., and Jong Hun Byun, M.D.; Korean J Gastrointest Endosc 2003;26(3):158-162. Published online March 31, 2003

Abstract PDF: Cytomegalovirus (CMV) is the most common cause of life-threatening opportunistic viral infection in patients with acquired immunodeficiency syndrome (AIDS). However, CMV infection may occur in the immunocompetent individuals. CMV colitis has not been reported in a patient with splenectomy in Korea. Recently, we experienced a case of fatal CMV colitis in a patient with splenectomy. A 69-year-old man complained of bloody mucoid diarrhea and abdominal pain for 2 months. He had the splenectomy 6 months ago. CMV colitis was diagnosed by colonoscopy and pathologic examination. He died of sepsis in spite of antiviral ganciclovir therapy. (Korean J Gastrointest Endosc 2003;26:158⁣162)

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A Case of CMV Infection Associated with: Ki Young Choi, M.D.*, Kwang Bum Cho, M.D., Jun Young Hwang, M.D., Woo Jin Jung, M.D.,; Korean J Gastrointest Endosc 2003;26(1):26-30. Published online January 30, 2003

Abstract PDF: Gastrointestinal cytomegalovirus (CMV) disease causes substantial morbidity and mortality in immunocompromised patients, especially in transplant recipients and those who infected with HIV. Although acute infection is generally asymptomatic or produces only non-specific symptoms in the immunocompetent host, acute CMV infection accompanies gastrointestinal ulceration in a small number of patients. The colon is the most common site of the infection, although it may occur in other gastrointestinal tract. CMV infection associated with simultaneous esophageal and colonic ulcers has not been reported in Korea. We report a patient with subarchnoid hemorrhage who had suffered from simultaneous esophageal and colonic ulcers associated with CMV infection which showed characteristic histologic findings of CMV infection. (Korean J Gastrointest Endosc 2003;26:26⁣30)

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거대세포바이러스 직장염: Korean J Gastrointest Endosc 2000;20(5):400-400. Published online November 30, 1999

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신이식 환자에서 대장 모균증 및 거대세포바이러스 혼합 감염과 식도의 거대세포바이러스 감염증: Korean J Gastrointest Endosc 2000;20(5):399-399. Published online November 30, 1999

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증례 : 식도 위장관 ; 후천성 면역 부전 환자에서 거대세포바이러스 감염과 관련된 회장 천공 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of Ileal Perforation Associated with Cytomegaloviral Enteritis in a Patient with Acquired Immune Deficiency Syndrome ): Korean J Gastrointest Endosc 1998;18(6):931-936. Published online November 30, 1997

Abstract PDF: We report a case of ileal perforation associated with Cytomegaloviral enteritis in a 62 years old man who was diagnosed as AIDS lately. The perforated lesian was located at distal ileum approximately 50 cm above ileo-cecal valve. The lesion was simply closed by surgery. There were numerous erythematous patches on the serosal surface of jejunoileum. His gastrofiberscopic examination revealed multiple shallow ulcers in distal esophagus and stomach. Mieroscopic findings of both surgical and endoscopic specimens showed characteristic cytonegalic cells with inclusion bodies. There were numerous cytomegalic endothelial cells found in the ileal specimen without direct evidence of vasculitis. The diagnosis was confirmed by colorimetric detection of cytomegalovirus DNA using in situ hybridization. (Korean J Gastrointest Endosc 18: 931- 936, 1998)

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증례 : 식도 위장관 ; Cytomegalovirus 에 의한 다발성 위장관 궤양 2예 ( Case Reports : Esophagus , Stomach & Intestine ; Two Cases of CMV Esophagitis and Proctitis ): Korean J Gastrointest Endosc 1998;18(5):763-768. Published online November 30, 1997

Abstract PDF: Gastrointestinal cytomegalovirus (CMV) disease most frequently occurs in adults with immune deficiency due to acquired immune deficiency syndrome (AIDS), organ trans- plantation, cancer chemotherapy, and steroid therapy. Because the number of patients with immune deficiency has increased in recent years in Korea and CMV is one of the most common infecting complications in these settings, the number of patients with CMV disease is also increasing. Most cases of CMV disease are due to reactivation of a latent virus. The pathogenesis of this intestinal disease is vascular endothelial involvement with subsequent ischemic mucosal injury. An endoscopy usually reveals large, well defined ulcers greater than 3 cm. Deep longitudinal serpiginous ulcers represent a coalescence of adjoining smaller ulcers. CMV infection produces a characteristic cytomegalic cell containing a intranuclear inclusion, which is sometimes surrounded by a clear halo ("owl's eye"). The presence of cytomegalic cells on mucosal biopsy specimens stained with hematoxylin and eosin has been considered the golden standard for establishing the diagnosis of CMV gastrointestinal disease. Immunohistochemistry with monoclonal antibody to CMV antigens and in situ hybridization for CMV DNA are useful in the diagnosis. We report 2 cases of CMV esophagitis and proctitis which showed characteristic endoscopic and histologic findings of the CMV infection. (Korean J Gastrointest Endosc 18: 763-768, 1998)

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증례 : 식도 위장관 ; 동종 골수 이식술 후 발생한 십이지장의 거대세포 바이러스 감염증 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of Cytomegalovirus Duodenitis Following an Allogenic Bone Marrow Transplantation ): Korean J Gastrointest Endosc 1998;18(3):392-397. Published online November 30, 1997

Abstract PDF: Cytomegalovirus(CMV) disease is one of the major causes of morbidity and mortality in immunocompromised patients, such as recipients of a solid organ or bone marrow allo-graft and patients with acquired immnune deficiency syndrome, CMV infection of the gastrointestinal tract may vary in location, extent, and clinical manifestation. As there is no pathognamonic endoscopic feature for CMV disease, a diagnosis of CMV infection has been made by confirming cytomegalic cells in mucosal specimens obtained from the gastrointestinal tract by an endoscopy. We repcet a case of a 38-year-old male patient with CMV duodenitis following an allogenic bone marrow transplantation(BMT), who had prolonged nausea and vomiting for 5 weeks after the BMT. He was diagnosed as having CMV duodenitis by identifying cytomegalic cells in duodenal mucosa biopsied by endoscopy and recovered after the treatment of ganciclovir. (Korean J Gastraintest Endosc 18: 392-396, 1998)

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증례 : 식도 위장관 ; 궤양성 대장염 치료 중 합병된 거대세포바이러스 대장염 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of Cytomegalvirus Colitis Developed during the Treatment of Ulcerative Colitis ): Korean J Gastrointest Endosc 1997;17(4):557-560. Published online November 30, 1996

Abstract PDF: Cytomegalovirus colitis has been reported infrequently in patients with underlying inflammatory bowel disease, and usually in those who are taking corticosteroid drugs. It has been implicated as a possible exacerbating factor of ulcerative colitis. We experienced a case of cytomegalovirus colitis developed in patient with ulcerative colitis during corticosteroid therapy. So we report the case with a brief review of literatures. (Korean J Gastrointest Endosc 17: 557-560, 1997)

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증례 : 식도 위장관 ; CMV 위 대장 감염 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A case of CMV Gastrointestinal Disease ): Korean J Gastrointest Endosc 1997;17(3):416-421. Published online November 30, 1996

Abstract PDF: Cytomegalovirus(CMV) commonly infects immunocompromised patient, including those with malignant disease, immunosuppression (particularly that induced by steroid therapy), organ transplantation AIDS. Involvement of the gastrointestinal tract is often associated with disseminated infection. Enteric involvement is expressed by inflammation, hemorhage, and ulceration. CMV is postulated to cause submucosal capillary and arteriolor vasculitis that can result in ischemic injury. CMV induced gastritic and colonic ulcers have not previously been reported in Korea. We report a patient of malignancy who had gastric & colonic ulcers assoicated with CMV infection whieh showed chracteristic histological finding of CMV infection in biopsed specimen. (Korean J Gastrointest Endosc 17: 416-420, 1997)

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악성종양 환자에서 발생한 Cytomegalovirus ( CMV ) 감염과 관련된 위궤양 2예 ( Cytomegalovirus ( CMV ) - associated Gastric Ulcer Proved by Dot - blot Hybridization ): Korean J Gastrointest Endosc 1992;12(2):237-242. Published online November 30, 1991

Abstract PDF: In gastrointestinal tract CMV has been implicated in inducing mucosal inflammatory and ulcerative lesions. More recently, increasing number of patients with CMV-associated gut lesions have been reported primarily in immunocompromised patients or occasionally in normal hosts. The colon is the most common site of the infection, although it might occur in other gastrointestinal tract such as esophagus, stomach, duodenum and terminal ileum. The diagnosis of CMV infection can often be difficult and must await serological conversian or viral cultures. (continue...)

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거대세포바이러스 대장염 1예 ( A Case of Cytomegalovirus Colitis ): Korean J Gastrointest Endosc 1992;12(1):107-110. Published online November 30, 1991

Abstract PDF: Cytomegalovirus colitis, invasive cytomegalovirus infection of colon, is an important opportunistic infection in immunosuppressed individuals. The clinical symptoms are abdominal pain, diarrhea, colionic hemorrhage and perforation. The endoscopic appearance show three characteristic features, 1) Focal or diffuse inflammatory changes: erythema, edema and erosion 2) Submucosal hemorrhagic spots 3) Clean-based, well demarcated ulcers(0.5-2 cm) We report a case of cytomegalovirus colitis in 41-year-old male with massive hematochezia, which confirmed by histopathologic findings in autopsy.

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