title: Fulminant gastrointestinal graft-versus-host disease concomitant with cytomegalovirus infection: case report and literature review.
abstract: Here, we report a case of fulminant gastrointestinal graft-versus-host disease (GI-GVHD) with cytomegalovirus (CMV) infection in 44-year-old woman. Despite the difficulties associated with the treatment of GI-GVHD and GI-CMV disease, the mucosal findings and the clinical course showed marked improvements during long-term clinical observation. The endoscopic findings were remarkable, with diffuse sloughing mucosa in the stomach and highly active inflammation and deep discrete ulcers throughout the colon. Changes in the CMV quantitative polymerase chain reaction results were correlated with the endoscopic mucosal findings and were useful for assessing the efficacy of the treatment. Although a definite diagnosis of GI-GVHD is generally made by endoscopy with biopsy, the gross appearance of this disease can vary depending on the endoscopy. In this paper, we also conduct a literature review of patients with GI-GVHD.
authors: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo 162-8655, Japan.
authors: Hidetaka
authors: H
authors: Okubo
authors: Naoyoshi
authors: N
authors: Nagata
authors: Naomi
authors: N
authors: Uemura
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005938:Glucocorticoids / Q000627:therapeutic use; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D005938:Glucocorticoids; D011239:Prednisolone; D015774:Ganciclovir
keywords: Acute gastrointestinal graft-versus-host disease; Allogenic stem-cell transplantation; Cytomegalovirus gastrointestinal disease; Cytomegalovirus-polymerase chain reaction; Endoscopy
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