title: Endoscopic diagnosis of cytomegalovirus gastritis after allogeneic hematopoietic stem cell transplantation.
abstract: 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.
authors.affiliation: Division of Endoscopy, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. yakakuga@ncc.go.jp
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kakugawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kami
authors.forename: Takahisa
authors.initials: T
authors.lastname: Matsuda
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Saito
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuda
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Mori
authors.forename: Tadakazu
authors.initials: T
authors.lastname: Shimoda
authors.forename: Ryuji
authors.initials: R
authors.lastname: Tanosaki
authors.forename: Daizo
authors.initials: D
authors.lastname: Saito
mesh_terms: 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
chemical_list: D000956:Antigens, Viral