CMV-Enterokolitis bei einer erwachsenen lebertransplantierten Patientin als Ursache rezidivierender Invaginationen?
| Autor: | Tim F. Greten, Oktay Tutarel, N. Saddekni, Kinan Rifai, P. Herzog, Michael Gebel, Jochen Wedemeyer, S. Pischke, Hannelore Barg-Hock, M.P. Manns, Christian P. Strassburg, Albert Heim |
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| Rok vydání: | 2010 |
| Předmět: |
Enterocolitis
medicine.medical_specialty Abdominal pain medicine.diagnostic_test business.industry medicine.medical_treatment Gastroenterology virus diseases Colonoscopy Liver transplantation medicine.disease Inflammatory bowel disease Coeliac disease Surgery Intussusception (medical disorder) Internal medicine medicine medicine.symptom Colitis business |
| Zdroj: | Zeitschrift für Gastroenterologie. 48:688-692 |
| ISSN: | 1439-7803 0044-2771 |
| DOI: | 10.1055/s-0028-1109770 |
| Popis: | Intestinal intussusception in the adult is often idiopathic but also known to be associated with chronic inflammatory bowel disease, coeliac disease, tumours or previous abdominal operations. A 22-year-old women after liver transplantation due to Crigler Najar Syndrome suffered from repeated episodes of abdominal pain. The diagnosis of repeated self-limited intestinal intussusceptions was made by computed tomography and ultrasonography. A laparoscopy revealed no cause for the intussusceptions. During a new episode of abdominal pain caused again by an intussusception a colonoscopy was performed that showed aspects of a discreet colitis. In the biopsies CMV was detected by qualitative PCR, while blood tests for CMV pp65 antigen were negative. A therapy with gancyclovir was initiated which lead to remission of the patient's symptoms. A colonoscopy six weeks later showed a completely normal colon, while in the biopsies CMV was not detectable. After a follow-up of one year the patient has not suffered from any further episodes. This case demonstrates the role of chronic intestinal CMV infection as a possible causative factor for repeated intussusceptions in immunosuppressed patients. Whenever possible a PCR for CMV in colon biopsies should be carried out to detect an intestinal CMV infection because as shown in our case results for immunohistopathology and CMV pp65 can be negative despite a chronic infection. |
| Databáze: | OpenAIRE |
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