title: Herpes simplex virus type 1 colitis in a patient with common variable immunodeficiency syndrome.
abstract: We report on a case of herpes simplex virus (HSV) type 1 colitis in a 69-year-old patient with common variable immunodeficiency syndrome. A treatment with polyvalent immunoglobulins was discontinued in April 2001. In March 2004 she developed chronic diarrhoea related to rectosigmoidal and caecal ulcerations. In November 2004, HSV was recovered in tissue culture from colonic biopsies. Valaciclovir was then started, leading the patient to clinical remission at day 4, and continued for a 6-week course (without any secondary antiviral prophylaxis). Colonic biopsies were negative for HSV by tissue culture and PCR within 3 weeks of antiviral treatment. Intravenous polyvalent immunoglobulin infusions were readministered within the third week of antiviral treatment. She has declared no clinical event since this period. Three months after the antiviral treatment was achieved, a rectosigmoidoscopy showed an ad-integrum macroscopic and histological mucosal healing whereas PCR was negative for HSV in the colonic tissue. As a large proportion of patients with common variable immunodeficiency syndrome present not only as a humoral immunodeficiency but also as a defect in the cellular immunity compartment (with T-cell deficits), HSV, as well as cytomegalovirus, should be investigated in patients with common variable immunodeficiency syndrome presenting colitis.
authors.affiliation: Service de Gastroentérologie et d'Assistance Nutritive, Hôpital Lariboisière, 2 rue Ambroise Parè, 75475 Paris cedex 10, France. xavier.dray@lrb.aphp.fr
authors.forename: Xavier
authors.initials: X
authors.lastname: Dray
authors.forename: Xavier
authors.initials: X
authors.lastname: Treton
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Mazeron
authors.forename: Anne
authors.initials: A
authors.lastname: Lavergne-Slove
authors.forename: Francisca
authors.initials: F
authors.lastname: Joly
authors.forename: Dora
authors.initials: D
authors.lastname: Mimram
authors.forename: Alain
authors.initials: A
authors.lastname: Attar
authors.forename: Gérard
authors.initials: G
authors.lastname: Tobelem
authors.forename: Yoram
authors.initials: Y
authors.lastname: Bouhnik
mesh_terms: D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D003092:Colitis / Q000276:immunology / Q000821:virology*; D003106:Colon / Q000276:immunology / Q000821:virology; D017074:Common Variable Immunodeficiency / Q000150:complications* / Q000276:immunology; D005260:Female; D006561:Herpes Simplex / Q000188:drug therapy / Q000276:immunology; D018259:Herpesvirus 1, Human / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood
chemical_list: D000914:Antibodies, Viral; D000998:Antiviral Agents; D007074:Immunoglobulin G; D007075:Immunoglobulin M