Okubo H, Nagata N, Uemura N. Fulminant gastrointestinal graft-versus-host disease concomitant with cytomegalovirus infection: Case report and literature review. World J Gastroenterol 2013; 19(4): 597-603 [PMID: 23382644 DOI: 10.3748/wjg.v19.i4.597]
Corresponding Author of This Article
Naoyoshi Nagata, MD, Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan. nnagata_ncgm@yahoo.co.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
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World J Gastroenterol. Jan 28, 2013; 19(4): 597-603 Published online Jan 28, 2013. doi: 10.3748/wjg.v19.i4.597
Fulminant gastrointestinal graft-versus-host disease concomitant with cytomegalovirus infection: Case report and literature review
Hidetaka Okubo, Naoyoshi Nagata, Naomi Uemura
Hidetaka Okubo, Naoyoshi Nagata, Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
Naomi Uemura, Department of Gastroenterology and Hepatology, Kohnodai Hospital, Ichikawa 272-0827, Chiba, Japan
Author contributions: Okubo H and Nagata N contributed equally to this work; Okubo H, Nagata N and Uemura N designed the research; Okubo H, Nagata N provided the discussion of the pathology and clinical features and wrote the paper.
Supported by Grant from the National Center for Global Health and Medicine
Correspondence to: Naoyoshi Nagata, MD, Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan. nnagata_ncgm@yahoo.co.jp
Telephone: +81-3-32027181 Fax: +81-3-32071038
Received: October 25, 2012 Revised: December 2, 2012 Accepted: December 15, 2012 Published online: January 28, 2013 Processing time: 95 Days and 16.7 Hours
Abstract
Here, we report a case of fulminant gastrointestinal graft-versus-host disease (GI-GVHD) with cytomegalovirus (CMV) infection in 44-year-old woman. Despite the difficulties associated with the treatment of GI-GVHD and GI-CMV disease, the mucosal findings and the clinical course showed marked improvements during long-term clinical observation. The endoscopic findings were remarkable, with diffuse sloughing mucosa in the stomach and highly active inflammation and deep discrete ulcers throughout the colon. Changes in the CMV quantitative polymerase chain reaction results were correlated with the endoscopic mucosal findings and were useful for assessing the efficacy of the treatment. Although a definite diagnosis of GI-GVHD is generally made by endoscopy with biopsy, the gross appearance of this disease can vary depending on the endoscopy. In this paper, we also conduct a literature review of patients with GI-GVHD.
