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ID 54977
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著者
Iwamuro, Masaya Department of General Medicine, Okayama University Graduate School of Medicine
Kondo, Eisei Department of General Medicine, Okayama University Graduate School of Medicine
Tanaka, Takehiro Department of Pathology, Okayama University Hospital
Hagiya, Hideharu Division of Infection Control and Prevention, Osaka University Hospital
Kawano, Seiji Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine
Kawahara, Yoshiro Departments of Endoscopy, Okayama University Hospital
Otsuka, Fumio Department of General Medicine, Okayama University Graduate School of Medicine 科研費研究者番号
Okada, Hiroyuki Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine 科研費研究者番号
抄録
We retrospectively analyzed the cases of 14 patients (9 women, 5 men, mean age: 51.6 years) with cytomegalovirus (CMV) involvement in the esophagus, stomach, and/or duodenum diagnosed at a single center, to determine their endoscopic features and clinical backgrounds. Thirteen patients (92.9%) had hematologic disease; the other had rheumatoid arthritis. Of the former, 12 patients underwent allogeneic hematopoietic stem cell transplantation, and 9 of these patients had graft-versus-host disease (GVHD) before undergoing esophagogastroduodenoscopy (EGD). All 14 patients had been taking one or more immunosuppressive agents including cyclosporine (n=10), corticosteroids (n=9), mycophenolic acid (n=6), tacrolimus (n=3), and methotrexate (n=1). Tests for CMV antigenemia were positive in 11 patients (78.6%). EGD examinations revealed esophageal (n=3), gastric (n=9), and duodenal involvement (n=6). Macroscopically, esophageal lesions by CMV infection presented as redness (n=1), erosions (n=1), and ulcers (n=1). Gastric lesions manifested as redness (n=7), erosions (n=3), exfoliated mucosa (n=2), and verrucous erosions (n=1). Mucosal appearances in the duodenum varied: redness (n=2), ulcers (n=2), multiple erosions (n=2), single erosion (n=1), edema (n=1). CMV was detected even in the intact duodenal mucosa (n=1). In conclusion, physicians must recall the relevance of CMV infection when any mucosal alterations exist in the upper gastrointestinal tract of immunosuppressed patients.
キーワード
cytomegalovirus
duodenum
esophagogastroduodenoscopy
esophagus
stomach
Amo Type
Original Article
発行日
2017-04
出版物タイトル
Acta Medica Okayama
71巻
2号
出版者
Okayama University Medical School
開始ページ
97
終了ページ
104
ISSN
0386-300X
NCID
AA00508441
資料タイプ
学術雑誌論文
言語
English
著作権者
CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン
publisher
査読
有り
PubMed ID