title: Postural epigastric pain: a challenging symptom for cytomegalovirus (CMV) gastritis.
abstract: Abstract   Postural epigastric pain is an uncommon symptom and is hardly acquired unless specifically asked to the patient. Here we present a cytomegalovirus (CMV) gastritis case in a renal transplant patient with postural epigastric pain. A 36-year-old male was admitted to our clinic on the 50th day of renal transplantation with postural epigastric pain. All investigations were unremarkable except biopsy-proven CMV gastritis and increased CMV viral load. The patient was free of symptom after ganciclovir treatment. Postural epigastric pain has not been described together with a clinical entity. Although not proved yet, it can be regarded as a unique symptom of CMV gastritis. Renal transplant patients presenting with postural epigastric pain which is not relieved with acid suppression should raise suspicion of CMV gastritis and this has to be confirmed by endoscopy and biopsy.
authors.affiliation: Department of Internal Medicine, Steward Carney Hospital, Tufts University School of Medicine, Boston, MA 02124, USA. umit.tapan@steward.org
authors.forename: Umit
authors.initials: U
authors.lastname: Tapan
authors.forename: Aysun Aybal
authors.initials: AA
authors.lastname: Kutlugun
authors.forename: Mustafa
authors.initials: M
authors.lastname: Arici
authors.forename: Bulent
authors.initials: B
authors.lastname: Altun
mesh_terms: D000328:Adult; D003586:Cytomegalovirus Infections / Q000150:complications*; D005756:Gastritis / Q000150:complications* / Q000821:virology*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D010146:Pain / Q000209:etiology*; D011183:Postoperative Complications / Q000821:virology*; D011187:Posture