severe colitis associated with both epstein-barr virus and cytomegalovirus reactivation in a patient with severe aplastic anemia

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ID: 178774
2014
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Abstract
Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are members of the herpesvirus family and common causes of viral infection in humans. CMV infection of the gastrointestinal tract occurs mainly in immunocompromised individuals, on the other hand EBV infection and reactivation involving the gastrointestinal tract is very rare. A 56-year-old man was diagnosed with severe aplastic anemia and treated with antithymocyte globulin (ATG) and cyclosporine (CSP). After 2 years of ATG/CSP therapy, he suddenly started passing bloody diarrhea and developed a high fever despite CSP treatment. Endoscopic features included severe edema and multiple superficial ulcers; the patient was initially diagnosed with severe colitis resembling inflammatory bowel disease (IBD). However, his symptoms did not resolve with steroid treatment. Immunohistochemical analysis of samples obtained from a second colonoscopy showed cells positive for CMV, and in situ hybridization revealed EBV-encoded small RNA-1-positive cells. Additionally, the patient's serum was positive for C7-HRP, and both blood and colon tissues were positive for EBV DNA, which was detected using PCR analysis. We finally diagnosed the patient with colitis associated with reactivation of both CMV and EBV. The patient remains diarrhea-free after 1.5 years with scheduled globulin treatment and after cessation of immunosuppressive drug therapy. To our knowledge, this is the first reported case of an immunodeficient patient with severe hemorrhagic colitis that was associated with reactivation of both EBV and CMV, and whose endoscopic findings mimicked IBD.
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matsumoto2014casesevere Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Hiroshi Matsumoto;Yoshiki Kimura;Takahisa Murao;Motoyasu Osawa;Takashi Akiyama;Kiyohito Mannoji;Risa Koresawa;Hirotoshi Tokunaga;Hideho Wada;Takashi Sugihara;Ken Haruma
Journal trends in genetics : tig
Year 2014
DOI
10.1159/000365546
URL
http://www.karger.com/Article/FullText/365546
Keywords
colitis cytomegalovirus Gastroenterology

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