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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2015; 21(43): 12505-12509
Published online Nov 21, 2015. doi: 10.3748/wjg.v21.i43.12505
Published online Nov 21, 2015. doi: 10.3748/wjg.v21.i43.12505
Cholestasis, ascites and pancytopenia in an immunocompetent adult with severe cytomegalovirus hepatitis
Jun-Yan Qian, Xiao-Yin Bai, Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Yun-Lu Feng, Fang Yao, Jing-Nan Li, Ai-Ming Yang, Jia-Ming Qian, Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Wen-Jia Zhu, Fang Li, Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Author contributions: Qian JY and Bai XY contributed equally to this work; Qian JY, Bai XY and Feng YL conceived and designed the study, and analyzed and interpreted data; Qian JY and Bai XY drafted the article; Zhu WJ and Li F performed imaging studies; Yao F, Li JN, Yang AM, Qian JM and Feng YL revised the article; and all the authors have read and approved the final version to be published.
Institutional review board statement: The study was reviewed and approved by the Peking Union Medical College Hospital Institutional Review Board.
Informed consent statement: The patient provided informed written consent for a case report in a scientific paper.
Conflict-of-interest statement: The authors declared no conflict of interest in this study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yun-Lu Feng, MD, Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. yunluf@gmail.com
Telephone: +86-10-69155017 Fax: +86-10-68419898
Received: May 6, 2015
Peer-review started: May 11, 2015
First decision: July 10, 2015
Revised: July 20, 2015
Accepted: September 14, 2015
Article in press: September 15, 2015
Published online: November 21, 2015
Peer-review started: May 11, 2015
First decision: July 10, 2015
Revised: July 20, 2015
Accepted: September 14, 2015
Article in press: September 15, 2015
Published online: November 21, 2015
Core Tip
Core tip: Human cytomegalovirus (CMV) can establish lifelong latency after primary infection. It also leads to severe disease in immunocompromised patients. However, CMV infection in immunocompetent patients is usually asymptomatic and severe organ damage is rarely reported. Here, we report an immunocompetent patient with a unique presentation of severe CMV hepatitis manifested by cholestasis, ascites and pancytopenia. The patient was asymptomatic with normal liver function and negative CMV DNA after two weeks of antiviral therapy. It is suggested that testing for CMV should be carried out, even in patients with normal immune status, presenting with severe liver damage or cholestasis.