Gastrointestinal cytomegalovirus disease in renal transplant recipients: a case series.
The purpose of this article was to report a series of 23 renal transplant recipients with histologically proven and immunohistochemically confirmed cytomegalovirus (CMV) lesions in the gastrointestinal tract (GIT) and to assess the risk factors associated with severe disease/mortality. CMV patients (n=23) were allocated into two groups: those who died (n=6) and those considered cured (n=17). Overall mortality rate was 26% (6/23). Initial symptoms suggestive of lower GIT involvement were observed in all death cases and in 35.3% of those cured (p=0.01). Enterorrhagia was seen in 83.3% of the patients who died. Death risk increased twofold (RR 2 [1.13-3.52], p=0.01) when symptoms of lower GIT involvement were initially observed and sixfold when enterrohagia was present (RR 6 [1.1-35.9], p=0.001). Among death cases, mean time at diagnosis was significantly more distant (2002±2.9×2008±1.6, p=0.04). The difference in mortality rates seen as service practices changed along the years demonstrates the importance of early diagnosis.
Department of Internal Medicine, Botucatu Medical School, Botucatu, Brazil. landrade@fmb.unesp.br
Luís G M
LG
de Andrade
Maria A M
MA
Rodrigues
Fernando G
FG
Romeiro
Maria F C
MF
Carvalho
D000328:Adult; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality / Q000821:virology; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy; D012307:Risk Factors