ID | 54977 |
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Iwamuro, Masaya
Department of General Medicine, Okayama University Graduate School of Medicine
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Kondo, Eisei
Department of General Medicine, Okayama University Graduate School of Medicine
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Hagiya, Hideharu
Division of Infection Control and Prevention, Osaka University Hospital
Kawano, Seiji
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine
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Kawahara, Yoshiro
Departments of Endoscopy, Okayama University Hospital
Otsuka, Fumio
Department of General Medicine, Okayama University Graduate School of Medicine
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Okada, Hiroyuki
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine
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Abstract | 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.
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Keywords | cytomegalovirus
duodenum
esophagogastroduodenoscopy
esophagus
stomach
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Amo Type | Original Article
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Publication Title |
Acta Medica Okayama
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Published Date | 2017-04
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Volume | volume71
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Issue | issue2
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Publisher | Okayama University Medical School
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Start Page | 97
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End Page | 104
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ISSN | 0386-300X
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NCID | AA00508441
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Content Type |
Journal Article
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language |
English
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Copyright Holders | CopyrightⒸ 2017 by Okayama University Medical School
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File Version | publisher
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Refereed |
True
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