Cytomegalovirus infection of the upper gastrointestinal tract: a clinical and pathological study of 30 cases

Bonetti, Luca Reggiani; Losi, Luisa; Gregorio, Carmela Di; Bertani, A.; Merighi, Antonio; Bettelli, Stefania; Scuri, Monica; Maiorana, Antonio

doi:10.3109/00365521.2011.594083

Cited by 42 publications

(26 citation statements)

References 27 publications

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“…Similar to previous studies, our research can emphasize that dysphagia, followed by epigastralgia and hematemesis, were common symptoms [2,5,7]. Earlier data on this topic showed that distal ulcers are more common than mucosal inflammation [7,19,20]. In general, ulcers seen in CMV-induced esophagitis tend to be large and deep, and are more likely to be found in the distal section of the esophagus.…”

Section: Discussionsupporting

confidence: 88%

“…The immunocompromised conditions most frequently reported by Wang as being associated with CMV-induced esophagitis are AIDS, followed by bone marrow transplantation, autoimmune diseases, and malignancies. On the other hand, Bonetti et al [19] have shown, in a case series of 30 patients with CMV-induced esophagitis, that 50% of them were immunocompetent hosts. In the present study, all four patients with CMV esophagitis were immunocompromised.…”

Section: Discussionmentioning

confidence: 97%

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Infectious Esophagitis in Romanian Children: From Etiology and Risk Factors to Clinical Characteristics and Endoscopic Features

Bordea

Pîrvan

Gheban

et al. 2020

JCM

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Objectives. The aim of this study is to provide information about prevalence, etiology, risk factors, clinical characteristics and endoscopic features of various types of infectious esophagitis in children. Methods. We performed a total of 520 upper gastrointestinal tract endoscopies in Pediatric Clinic II, Emergency Hospital for Children, Cluj-Napoca. Indications for endoscopy in our cohort were gastrointestinal tract symptoms such as dysphagia, heartburn, or appetite loss. Results. The prevalence of infectious esophagitis in the study population was 2.11% (11 patients). Candida albicans (C. albicans) was the most frequent cause. Our data illustrates that herpes simplex virus (HSV)-induced esophagitis is common in immunocompromised patients and should be systematically suspected in cases of severe dysphagia, heartburn, or hematemesis. In the present study, all cytomegalovirus (CMV) esophagitis patients were immunocompromised. Immunodeficiency (81.8%) and prolonged antibiotic therapy with broad-spectrum antibiotics were by far the most important risk factors involved in the pathogenicity of the disease. Dysphagia, appetite loss, heartburn, epigastralgia, and hematemesis were the main clinical manifestations. Infectious esophagitis was associated with significant mortality. In four patients, endoscopy during life showed signs of infectious esophagitis; however, the precise etiology was only established post-mortem, in the pathological anatomy laboratory department. A risk factor involved in pathogenesis of post-mortem diagnosed infectious esophagitis is the DiGeorge syndrome for CMV and HSV patients. Conclusions. The study illustrates that infectious esophagitis should be considered in immunocompromised infants with prolonged antibiotic therapy with broad-spectrum antibiotics.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 97%

Infectious Esophagitis in Romanian Children: From Etiology and Risk Factors to Clinical Characteristics and Endoscopic Features

Bordea

Pîrvan

Gheban

et al. 2020

JCM

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“…The differential diagnosis of erosions include other relatively infrequent etiologies, such as cytomegalovirus infection [8], vasculitis [9], amyloidosis [10], gastrinoma, and duodenal adenocarcinoma. On the other hand, whitish lesions in the duodenum may be caused by various etiologies, such as normal lymph follicles, intestinal lymphangiectasia, chronic non-specific duodenitis, and giardiasis [11].…”

Section: Discussionmentioning

confidence: 99%

Primary Follicular Lymphoma of the Duodenum with Erosions as Atypical Macroscopic Features

Takeuchi

Iwamuro

Imagawa

et al. 2012

Case Reports in Medicine

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A 52-year-old Japanese woman who was eventually diagnosed with primary follicular lymphoma of the duodenum showed atypical endoscopic features, namely, erosions with peripheral whitish edematous mucosa. Initial biopsy specimens taken from the erosions revealed insufficient numbers of lymphoma cells for histological diagnosis. Subsequent biopsy specimens from the peripheral mucosa containing the whitish enlarged villi showed infiltration of the lymphoma cells forming lymphoid follicles, which led us to the appropriate diagnosis. This case indicates that endoscopists should take biopsy samples from the peripheral mucosa with whitish enlarged villi rather than erosions in the rare instances that erosions appear as the main macroscopic feature of intestinal follicular lymphoma.

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“…A 2011 study of CMV infection in the upper GI tract, found the stomach to be the most common site of involvement and only one out of thirty cases involved the duodenum [6]. Literature review identified four case reports of CMV duodenitis [7], [8], [9], [10], where all four cases involved immunocompromised patients.…”

Section: Discussionmentioning

confidence: 99%

“…CMV duodenitis is exceedingly rare [6]. Presented is a case report of CMV duodenitis that manifested with life-threatening hemorrhage in an immunocompetent patient.…”

Section: Introductionmentioning

confidence: 99%

Cytomegalovirus duodenitis associated with life-threatening duodenal hemorrhage in an immunocompetent patient: A case report

Shen

Youssef

Abu-Abed

et al. 2017

International Journal of Surgery Case Reports

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Cytomegalovirus infection of the upper gastrointestinal tract: a clinical and pathological study of 30 cases

Abstract: Endoscopic manifestations of UGI tract involvement in HCMV infection are not specific, varying from erythematous mucosa to ulcers to mucosal thickenings.

Cited by 42 publications

References 27 publications

Infectious Esophagitis in Romanian Children: From Etiology and Risk Factors to Clinical Characteristics and Endoscopic Features

Infectious Esophagitis in Romanian Children: From Etiology and Risk Factors to Clinical Characteristics and Endoscopic Features

Primary Follicular Lymphoma of the Duodenum with Erosions as Atypical Macroscopic Features

Cytomegalovirus duodenitis associated with life-threatening duodenal hemorrhage in an immunocompetent patient: A case report

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