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Alimentary Tract| Volume 53, ISSUE 6, P722-728, June 2021

Cytomegalovirus gastritis: Clinicopathological profile

  • Pai-Jui Yeh
    Affiliations
    Department of Pediatric Gastroenterology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
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  • Cheng-Tang Chiu
    Affiliations
    Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, Taoyuan, Taiwan

    Taiwan Association of the Study of Small Intestinal Disease, Taiwan
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  • Ming-Wei Lai
    Affiliations
    Department of Pediatric Gastroenterology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan

    Taiwan Association of the Study of Small Intestinal Disease, Taiwan

    Liver Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taiwan
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  • Ren-Chin Wu
    Affiliations
    Department of Pathology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
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  • Chia-Jung Kuo
    Affiliations
    Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, Taoyuan, Taiwan

    Taiwan Association of the Study of Small Intestinal Disease, Taiwan
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  • Jun-Te Hsu
    Affiliations
    Department of General Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
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  • Ming-Yao Su
    Affiliations
    Taiwan Association of the Study of Small Intestinal Disease, Taiwan

    Department of Gastroenterology and Hepatology, New Taipei City Municipal Tucheng Hospital (Chang Gung Memorial Hospital), Tucheng branch, Taiwan
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  • Puo-Hsien Le
    Correspondence
    Corresponding author.
    Affiliations
    Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, Taoyuan, Taiwan

    Taiwan Association of the Study of Small Intestinal Disease, Taiwan

    Liver Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taiwan
    Search for articles by this author
Published:January 11, 2021DOI:https://doi.org/10.1016/j.dld.2020.12.002

      Abstract

      Background

      Cytomegalovirus (CMV) gastritis is occasionally reported in case reports and limited case series. Up to now, it is the largest and most comprehensive retrospective study of CMV gastritis.

      Methods

      All patients who were histologically diagnosed with CMV gastritis at Linkou Chang Gung Memorial Hospital between January 2000 and April 2020 were included. Patients were divided into two groups according to immunity. Between-group differences in characteristics, manifestations, endoscopic features, prognostic factors, and outcomes were analyzed. The main endpoint was 3-month mortality.

      Results

      A total of 54 patients (34 immunocompromised, 20 immunocompetent) were enrolled. Common presentations included gastrointestinal bleeding (35.2%), abdominal pain (33.3%) and fever (31.5%). The endoscopic features included ulcer (88.9%) and inflammation (11.1%). The 3-month mortality rate was 20.4% and overall mortality rate was 40.7%. Acute kidney injury was the only independent risk factor for 3-month mortality (OR 53.89, 95%CI 1.56–1861.73, p = 0.027). Anti-viral therapy and host immune status did not affect 3-month mortality.

      Conclusion

      Both immunocompromised and immunocompetent patients with CMV gastritis have high mortality rates, without significant between-group differences. Acute kidney injury is the only independent predictive factor for 3-month mortality. Prevention of acute kidney injury may possibly improve the 3-month mortality rate.

      Keywords

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      References

        • Chaemsupaphan T.
        • Limsrivilai J.
        • Thongdee C.
        • et al.
        Patient characteristics, clinical manifestations, prognosis, and factors associated with gastrointestinal cytomegalovirus infection in immunocompetent patients.
        BMC Gastroenterol. 2020; 20: 22
        • You D.M.
        • Johnson M.D.
        Cytomegalovirus infection and the gastrointestinal tract.
        Curr Gastroenterol Rep. 2012; 14: 334-342
        • Nasa M.
        • Sharma Z.
        • Sud R.
        • Lipi L.
        Cytomegalovirus infection of gastrointestinal tract.
        Community Acquired Infect. 2016; 3
        • Lin W.R.
        • Su M.Y.
        • Hsu C.M.
        • et al.
        Clinical and endoscopic features for alimentary tract cytomegalovirus disease: report of 20 cases with gastrointestinal cytomegalovirus disease.
        Chang Gung Med J. 2005; 28: 476-484
        • Marques S.
        • Carmo J.
        • Pinto D.
        • Bispo M.
        • Ramos S.
        • Chagas C.
        Cytomegalovirus disease of the upper gastrointestinal tract: a 10-year retrospective study.
        GE Port J Gastroenterol. 2017; 24: 262-268
        • Reggiani Bonetti L.
        • Losi L.
        • Di Gregorio C.
        • et al.
        Cytomegalovirus infection of the upper gastrointestinal tract: a clinical and pathological study of 30 cases.
        Scand J Gastroenterol. 2011; 46: 1228-1235
        • Chen D.
        • Zhao R.
        • Cao W.
        • et al.
        Clinical characteristics of cytomegalovirus gastritis: a retrospective study from a tertiary medical center.
        Medicine (Baltimore). 2020; 99: e18927
        • Le P.H.
        • Lin W.R.
        • Kuo C.J.
        • et al.
        Clinical characteristics of cytomegalovirus colitis: a 15-year experience from a tertiary reference center.
        Ther Clin Risk Manag. 2017; 13: 1585-1593
        • Le P.H.
        • Kuo C.J.
        • Wu R.C.
        • et al.
        Pancolitis associated with higher mortality risk of cytomegalovirus colitis in patients without inflammatory bowel disease.
        Ther Clin Risk Manag. 2018; 14: 1445-1451
        • Khan T.V.
        • Toms C.
        Cytomegalovirus colitis and subsequent new diagnosis of inflammatory bowel disease in an immunocompetent host: a case study and literature review.
        Am J Case Rep. 2016; 17: 538-543
        • Galiatsatos P.
        • Shrier I.
        • Lamoureux E.
        • Szilagyi A.
        Meta-analysis of outcome of cytomegalovirus colitis in immunocompetent hosts.
        Dig Dis Sci. 2005; 50: 609-616
        • Bernard S.
        • Germi R.
        • Lupo J.
        • et al.
        Symptomatic cytomegalovirus gastrointestinal infection with positive quantitative real-time PCR findings in apparently immunocompetent patients: a case series.
        Clin Microbiol Infect. 2015; 21 (e1-7): 1121
        • Ebisutani C.
        • Kawamura A.
        • Shibata N.
        • et al.
        Gastric ulcer associated with cytomegalovirus in an immunocompetent patient: method for diagnosis.
        Case Rep Gastroenterol. 2012; 6: 365-368
        • Gravito-Soares E.
        • Almeida N.
        Cytomegalovirus disease of the upper gastrointestinal tract: an emerging infection in immunocompetent hosts.
        GE Port J Gastroenterol. 2017; 24: 259-261
        • Himoto T.
        • Goda F.
        • Okuyama H.
        • et al.
        Cytomegalovirus-associated acute gastric mucosal lesion in an immunocompetent host.
        Intern Med. 2009; 48: 1521-1524