Clinical characteristics of cytomegalovirus gastritis: A retrospective study from a tertiary medical center

Medicine (Baltimore). 2020 Jan;99(5):e18927. doi: 10.1097/MD.0000000000018927.

Abstract

Cytomegalovirus (CMV) gastritis is a rare opportunistic infection with diverse clinical manifestations. Our study aimed to investigate the clinical features of Chinese patients with CMV gastritis.Six inpatients diagnosed with CMV gastritis were retrospectively enrolled, based on the finding of inclusion bodies in routine hematoxylin and eosin staining or positive anti-CMV monoclonal antibodies under immunohistochemistry in the gastric biopsy. Data, including demographics, diagnostic measurements, and medications, were collected.Abdominal pain was the most frequently reported symptom, occurring in 4 patients. Five patients were immunocompromised with associated underlying diseases, and 3 patients had decreased leukocyte differentiation antigen 4 positive (CD4) T lymphocyte counts. Only 3 patients had either positive cytomegalovirus (CMV)-immunoglobulin (Ig) M or increased copies of CMV-DNA peripherally. All patients had gastric lesions in the antrum of the stomach, including ulcers or erosions observed by gastroscopy. All patients received ganciclovir by intravenous injection (IV) as the first line anti-CMV therapy, and attained complete (4) or partial remission (2) during the follow-up.CMV gastritis should be taken into consideration in patients with immunocompromised status who have abdominal pain, nausea, or vomiting. Gastroscopy and necessary biopsy are the major diagnostic methods for CMV gastritis. Early diagnosis leads to a better prognosis for these patients.

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / drug therapy
  • Abdominal Pain / epidemiology
  • Abdominal Pain / etiology
  • Adult
  • Aged
  • Biomarkers / blood
  • Biopsy
  • Cytomegalovirus Infections / diagnosis*
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / epidemiology*
  • Cytomegalovirus Infections / pathology
  • Female
  • Gastritis / diagnosis*
  • Gastritis / drug therapy
  • Gastritis / epidemiology*
  • Gastritis / pathology
  • Gastroscopy
  • Humans
  • Male
  • Middle Aged
  • Nausea / diagnosis
  • Nausea / drug therapy
  • Nausea / epidemiology
  • Nausea / etiology
  • Prognosis
  • Retrospective Studies
  • Stomach / diagnostic imaging
  • Stomach / pathology
  • Tertiary Care Centers
  • Vomiting / diagnosis
  • Vomiting / drug therapy
  • Vomiting / epidemiology
  • Vomiting / etiology

Substances

  • Biomarkers