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A Case of Cytomegalovirus Colitis which Occurred During Treatment of Hemophagocytic Syndrome

Journal of the Korean Pediatric Society 2001;44(9):1075-1080.
Published online September 15, 2001.
A Case of Cytomegalovirus Colitis which Occurred During Treatment of Hemophagocytic Syndrome
Sang-Nam Bae1, Sung-Ryon Ahn1, Yun-Jin Lee1, Young-Tak Lim1, Jae-Hong Park1, Kyung-Un Choi2, Chang-Hun Lee2
1Department of Pediatrics, College of Medicine, Busan National University, Busan, Korea
2Department of Pathology, Busan National University, Busan, Korea
식혈증후군의 치료 중에 발병한 거대세포 바이러스 대장염 1례
배상남1, 안성연1, 이윤진1, 임영탁1, 박재홍1, 최경운2, 이창훈2
1부산대학교 의과대학 소아과학교실
2부산대학교 의과대학 병리학과교실
Abstract
Cytomegalovirus(CMV) colitis is an important opportunistic infection in immunocompromised individuals. The clinical symptoms are abdominal pain, diarrhea, colonic hemorrhage and perforation. The endoscopic appearance shows three characteristic features with focal or diffuse inflammatory changes, submucosal hemorrhagic spots, and well demarcated ulcers. We experienced a case of CMV colitis in an 8-year-old girl presented with Stevens-Johnson syndrome, vanishing bile duct syndrome and infection-associated hemophagocytic histiocytosis, which developed during chemotherapy with etoposide and dexamethasone for hemophagocytic syndrome. The impaired immunity caused by chemotherapy is the most likely possible cause of CMV colitis in this case. We confirmed this case by endoscopic findings, the presence of cytomegalic cells on mucosal biopsy specimens, immunohistochemistry with monoclonal antibody to CMV antigen, and serologic study, and report with a brief review of the literature.
Key Words: Cytomegalovirus, Colitis


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