Cytomegalovirus colitis following immunosuppressive therapy for lupus peritonitis and lupus nephritis.
We report a woman with lupus nephritis complicated with lupus peritonitis and cytomegalovirus (CMV) colitis. Diagnosis of lupus peritonitis was made by abdominal computed tomography scan, colonoscopy, and ascitic fluid analysis. Steroid and cyclophosphamide therapy resulted in the improvement of severe lupus nephritis and peritonitis. Thereafter, she developed multiple colonic ulcers as diagnosed by colonoscopy and positive CMV antigenemia assay. Treatment with ganciclovir resulted in the disappearance of colonic lesions. The low cluster of differentiation (CD)4+ lymphocyte count (41/mm3) suggested that the cell-mediated immunity of this patient was comparable to that seen in patients with acquired immunodeficiency syndrome (AIDS).
Division of Nephrology, Seirei Hamamatsu General Hospital, Hamamatsu.
Naro
N
Ohashi
Taisuke
T
Isozaki
Kentaro
K
Shirakawa
Naoki
N
Ikegaya
Tatsuo
T
Yamamoto
Akira
A
Hishida
D000328:Adult; D003092:Colitis / Q000175:diagnosis / Q000209:etiology / Q000821:virology*; D003113:Colonoscopy; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000276:immunology*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy*; D008181:Lupus Nephritis / Q000188:drug therapy*; D010538:Peritonitis / Q000188:drug therapy* / Q000209:etiology; D011239:Prednisolone / Q000627:therapeutic use*
D007166:Immunosuppressive Agents; D011239:Prednisolone