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KMID : 1038820150180010060
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Pediatric Gastroenterology, Hepatology & Nutrition
2015 Volume.18 No. 1 p.60 ~ p.65
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Disseminated Cytomegalovirus Infection and Protein Losing Enteropathy as Presenting Feature of Pediatric Patient with Crohn’s Disease
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Murat Cakir
Safak Ersoz
Ulas Emre Akbulut
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Abstract
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We report a pediatric patient admitted with abdominal pain, diffuse lower extremity edema and watery diarrhea fortwo months. Laboratory findings including complete blood count, serum albumin, lipid and immunoglobulin levelswere compatible with protein losing enteropathy. Colonoscopic examination revealed diffuse ulcers with smoothraised edge (like "punched out holes") in the colon and terminal ileum. Histopathological examination showed activecolitis, ulcerations and inclusion bodies. Immunostaining for cytomegalovirus was positive. Despite supportive management,antiviral therapy, the clinical condition of the patient worsened and developed disseminated cytomegalovirusinfection and the patient died. Protein losing enteropathy and disseminated cytomegalovirus infection a presentingof feature in steroid-naive patient with inflammatory bowel disease is very rare. Hypogammaglobulinemia associatedwith protein losing enteropathy in Crohn’s disease may predispose the cytomegalovirus infection in previouslyhealthy children.
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KEYWORD
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Crohn disease, Cytomegalovirus infections, Protein-losing enteropathies
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