Endoscopic diagnosis of cytomegalovirus gastritis after allogeneic hematopoietic stem cell transplantation.
OBJECTIVE
To clarify the endoscopic and clinical findings of cytomegalovirus (CMV) gastritis after allogeneic hematopoietic stem cell transplantation (allo-SCT).


METHODS
Between 1999 and 2005, 523 patients underwent allo-SCT at our hospital, and 115 of these patients with gastrointestinal symptoms underwent esophagogastroduodenoscopy.


RESULTS
CMV gastritis was diagnosed pathologically in seven patients (1.3%) with the other 108 patients serving as controls. Six of the seven patients developed positive CMV antigenemia, and five complained of abdominal pain. Development of abdominal pain preceded CMV antigenemia in four of the five patients. Endoscopic examination showed oozing (n = 2), erosion (n = 6), and redness (n = 5) in the seven patients with CMV gastritis, while the control patients showed oozing (n = 3), erosion (n = 24), and redness (n = 100). Erosion and oozing were more frequently documented in patients with CMV gastritis compared with the controls, and the differences were statistically significant (P = 0.0012 and 0.029, respectively). CMV inclusion bodies were documented in 12 of 14 biopsy specimens obtained from erosive lesions, while they were identified in 4 of 15 biopsy specimens obtained from lesions other than erosions (P = 0.0025).


CONCLUSIONS
This study suggests that erosion and oozing, as well as abdominal pain, are useful indicators in the diagnosis of CMV gastritis following allo-SCT.
Kakugawa
Yasuo
Y
Division of Endoscopy, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. yakakuga@ncc.go.jp
Kami
Masahiro
M
Matsuda
Takahisa
T
Saito
Yutaka
Y
Kim
Sung-Won
SW
Fukuda
Takahiro
T
Mori
Shinichiro
S
Shimoda
Tadakazu
T
Tanosaki
Ryuji
R
Saito
Daizo
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000956:Antigens, Viral / Q000097:blood; D016022:Case-Control Studies; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000209:etiology / Q000821:virology; D016145:Endoscopy, Digestive System; D005260:Female; D005756:Gastritis / Q000175:diagnosis* / Q000209:etiology / Q000821:virology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous; D055815:Young Adult
D000956:Antigens, Viral