title: A case of steroid-refractory ulcerative colitis complicated with cytomegalovirus pneumonia.
abstract: We present a case of late-onset ulcerative colitis (UC) complicated with cytomegalovirus (CMV) pneumonia revealed by autopsy. A 77-year-old woman had a diagnosis of UC, and received high-dose steroids and leukocytapheresis. Then she received ganciclovir because CMV-pp65 antigenemia test revealed positive which suggested systemic or colonic CMV infection. But ganciclovir was discontinued because of thrombocytopenia and liver dysfunction. After that she had interstitial pneumonia and died of a respiratory failure. Autopsy revealed CMV colitis based on UC, and CMV pneumonia with diffuse alveolar damage. Evaluation of CMV infection in patients with steroid-refractory UC should be considered before proceeding with immunosuppressive therapy or surgery, especially in elderly patients.
authors.affiliation: Department of Internal Medicine II, Fukushima Medical University School of Medicine, Fukushima, 960-1295, Japan. shuzo@fmu.ac.jp
authors.forename: Shuzo
authors.initials: S
authors.lastname: Sato
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Rie
authors.initials: R
authors.lastname: Saito
authors.forename: Tomomi
authors.initials: T
authors.lastname: Sasajima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Orikasa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Tasaki
authors.forename: Masafumi
authors.initials: M
authors.lastname: Abe
mesh_terms: D000368:Aged; D003093:Colitis, Ulcerative / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D011024:Pneumonia, Viral / Q000150:complications* / Q000473:pathology; D013256:Steroids / Q000009:adverse effects
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids