Journal Article Cytomegalovirus as an Insidious Pathogen Causing Duodenitis

Hagiya, Hideharu  ,  Iwamuro, Masaya  ,  Tanaka, Takehiro  ,  Hanayama, Yoshihisa  ,  Otsuka, Fumio

69 ( 5 )  , pp.319 - 323 , 2015-10 , Okayama University Medical School
A 60-year-old woman with rheumatoid arthritis treated with methotrexate for a decade complained of slight epigastric discomfort. A positive cytomegalovirus (CMV) antigenemia test indicated the probability of CMV-related gastrointestinal infection, for which esophagogastroduodenoscopy was performed. Endoscopic findings showed a non-specific duodenal mucosal lesion;however, pathological investigation revealed evidence of CMV duodenitis. There is scarce information on the clinical and pathological features of CMV-related duodenitis, likely due to its low prevalence. CMV infection in the upper gastrointestinal tract should be considered as a differential diagnosis in high-risk individuals, particularly those with symptoms relating to the digestive system. Biopsy examinations are preferable for the definitive diagnosis of CMV gastrointestinal infection, even without specific endoscopic features.

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