title: Cytomegalovirus ischemic colitis and transverse myelitis in a renal transplant recipient.
abstract: We report a rare case of cytomegalovirus (CMV)-associated ischemic colitis and transverse myelitis (TM) occurring precociously after renal transplantation. A 57-year-old male was transplanted with a cadaveric kidney on 5 June 2009. The patient was CMV seropositive and the donor was seronegative. Transplantation was followed shortly by TM, which resulted in paraplegia. The results of magnetic resonance imaging of the spinal cord showed abnormalities. Twenty days after transplantation, he developed abdominal pain with melena and was diagnosed as having CMV-associated ischemic colitis confirmed by colonoscopy and biopsy. Serological data and identification of the viral genome by polymerase chain reaction were confirmatory for CMV. Treatment consisted of intravenous ganciclovir, followed by polyvalent immunoglobulin. The outcome was favorable. Symptomatic CMV infection is relatively common among the renal transplant population. Early colonoscopy is beneficial for making a quick diagnosis and therefore helps to institute a prompt management of CMV colitis. Myelitis is less common in transplant recipients and diagnosis, therefore, was more difficult.
authors.affiliation: Department of Nephrology, Hospital Fattouma Bourguiba, Monastir, Tunisia. imen_gorsane@voila.fr
authors.forename: Imen
authors.initials: I
authors.lastname: Gorsane
authors.forename: Sabra
authors.initials: S
authors.lastname: Aloui
authors.forename: Ahmed
authors.initials: A
authors.lastname: Letaif
authors.forename: Rim
authors.initials: R
authors.lastname: Hadhri
authors.forename: Faouzi
authors.initials: F
authors.lastname: Haouala
authors.forename: Ameur
authors.initials: A
authors.lastname: Frih
authors.forename: Naceur Ben
authors.initials: NB
authors.lastname: Dhia
authors.forename: Mezri
authors.initials: M
authors.lastname: Elmay
authors.forename: Habib
authors.initials: H
authors.lastname: Skhiri
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D017091:Colitis, Ischemic / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D003113:Colonoscopy; D003587:Cytomegalovirus / Q000235:genetics; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008551:Melena / Q000209:etiology; D008875:Middle Aged; D009188:Myelitis, Transverse / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D015774:Ganciclovir