Unusual endoscopic findings of CMV esophagitis after liver transplantation.
Cytomegalovirus infections are associated with a high mortality rate after liver transplantation, but they are treated successfully by administration of the combination of ganciclovir plus intravenous immunoglobulin. We herein describe cytomegalovirus esophagitis in a patient having gastrointestinal symptoms such as dysphagia, retrosternal pain and epigastralgia after liver transplantation was detected by performing the surveillance of endoscopy. At first, the findings of endoscopy that were segmental erosive areas but no ulcerative areas on the esophageal lumen were unusual in this case of cytomegalovirus infections, but cytomegalovirus esophagitis was confirmed by cytomegalovirus immunohistochemical stain using biopsies. The patient was treated by ganciclovir at an oral dosage of 5mg/kg twice a day for 2 weeks. Our experience suggests that cytomegalovirus esophagitis should be taken into consideration when a patient has gastrointestinal symptoms such as dysphagia, retrosternal pain and epigastralgia and has endoscopic findings such as segmental erosions on the esophageal lumen despite having no cytomegalovirus-specific endoscopic findings such as ulcerative lesions.
Department of Surgery and Medical Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. nharada@surg2.med.kyushu-u.ac.jp
Noboru
N
Harada
Mitsuo
M
Shimada
Taketoshi
T
Suehiro
Yuji
Y
Soejima
Mizuki
M
Ninomiya
Satoko
S
Shiotani
Keizo
K
Sugimachi
D000998:Antiviral Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology*; D004941:Esophagitis / Q000188:drug therapy / Q000473:pathology* / Q000821:virology*; D004945:Esophagoscopy; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged
D000998:Antiviral Agents; D015774:Ganciclovir