title: Cytomegalovirus ileocolitis in a rheumatoid arthritis patient: case report and literature review.
abstract: Rheumatoid arthritis (RA) is an autoimmune, systemic, chronic, inflammatory disease generally treated with various immunosuppressive drugs. Cytomegalovirus (CMV) is an opportunistic, viral infection that is commonly seen in immunosuppressed patients. A sixty-four-year old female diagnosed with RA and treated with immunosuppressive agents was admitted to our rheumatology outpatient service with complaints of diarrhea and abdominal pain, which had lasted longer than four weeks. The patient's colonoscopy revealed inflamed and ulcerated areas in the colon and in the terminal ileum. A biopsy showed intra-nuclear inclusion particles consistent with CMV. We started an oral valganciclovir therapy in this serum-CMV-polymerase chain reaction-positive patient. The concomitant use of immunosuppressive agents and anti-viral drugs eased the patient's complaints, and the endoscopic picture improved. Consequently, cytomegalovirus ileocolitis in immunosuppressed patients admitted with severe diarrhea must be considered in the differential diagnosis.
authors.affiliation: Department of Internal Medicine, School of Medicine, Gaziantep University. drmsait@windovslive.com.
authors.forename: M S
authors.initials: MS
authors.lastname: Dag
authors.forename: I H
authors.initials: IH
authors.lastname: Turkbeyler
authors.forename: Z A
authors.initials: ZA
authors.lastname: Ozturk
authors.forename: B
authors.initials: B
authors.lastname: Kısacık
authors.forename: E
authors.initials: E
authors.lastname: Tutar
authors.forename: A
authors.initials: A
authors.lastname: Kadayıfçı
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000175:diagnosis; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology*; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000150:complications*; D004359:Drug Therapy, Combination; D005260:Female; D015774:Ganciclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D016896:Treatment Outcome; D000077562:Valganciclovir
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D000077562:Valganciclovir; D015774:Ganciclovir