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KMID : 0359020090390030176
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Korean Journal of Gastrointestinal Endoscopy
2009 Volume.39 No. 3 p.176 ~ p.180
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Cytomegalovirus Colitis in an Immunocompetent Patient with Henoch-Scho?nlein Purpura
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Yoon Jung-Yoon
Song Dong-Eun
Shim Ki-Nam
Jung Sung-Ae
Yoo Kwon
Kang Min-Jung
Kim Seong-Eun
Song Hyun-Joo
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Abstract
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Most cases of cytomegalovirus (CMV) colitis occur in adults with severe immuno- deficiency. There have been a few reports involving immunocompetent patients. CMV colitis may occur after colonic mucosal injury in immunocompetent patients. Henoch-Scho?nlein purpura (HSP) is a common systemic vasculitis in childhood. Diagnostic criteria include palpable purpura with at least one other manifestation; abdominal pain, IgA deposition, arthritis or arthralgia, or renal involvement. To best of our knowledge, we describe the first case of CMV colitis in an immunocompetent patient with preceding HSP. A 38-year-old man presented with a 1-day history of abdominal pain, diarrhea and vomiting. Two-years previously, he underwent a right hemicolectomy due to intussusception. Over a 1-month period, palpable purpura was evident on both arms and legs. Colonoscopy revealed multiple, linear geographic ulcerations at an anastomosis opening site with huge ulceration at the small bowel, which was covered with white exudates. Colonoscopic biopsy showed CMV inclusion bodies and skin biopsy revealed leukocytoclastic vasculitis. The patient was successfully treated with gancyclovir and prednisolone
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KEYWORD
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Cytomegalovirus, Henoch-Scho?nlein purpura
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