Korean J Gastrointest Endosc > Volume 39(3); 2009 > Article
Korean Journal of Gastrointestinal Endoscopy 2009;39(3): 176-180.
Henoch-Schönlein 자반증이 동반된 거대 세포 바이러스 장염 1예
윤정윤ㆍ정성애ㆍ송현주ㆍ강민정ㆍ김성은ㆍ심기남ㆍ유 권ㆍ송동은*
이화여자대학교 의학전문대학원 내과학교실, *해부병리학교실, 의과학연구소
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.*
Departments of Internal Medicine and *Pathology, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
Abstract
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)
Key Words: Cytomegalovirus, Henoch-SchoҨnlein purpura
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