A CASE OF TOXIC MEGACOLON IN ULCERATIVE-COLITIS ASSOCIATED WITH CYTOMEGALOVIRUS-INFECTION

被引：29

作者：

KOTANAGI, H

FUKUOKA, T

SHIBATA, Y

YOSHIOKA, T

AIZAWA, O

SAITO, Y

KOYAMA, K

OTAKA, M

CHIBA, M

SAITO, M

机构：

[1] First Department of Surgery, Akita University School of Medicine, Akita, 010

[2] First Department of Internal Medicine, Akita University School of Medicine, Akita, 010

[3] First Department of Pathology, Akita University School of Medicine, Akita, 010

来源：

JOURNAL OF GASTROENTEROLOGY | 1994年 / 29卷 / 04期

关键词：

ULCERATIVE COLITIS; TOXIC MEGACOLON; CYTOMEGALIC INCLUSION DISEASE;

D O I：

10.1007/BF02361250

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Cytomegalovirus (CMV) infection, which has been shown to complicate the course of ulcerative colitis (UC), has been implicated as a possible etiologic factor in the exacerbation of UC, especially in toxic megacolon. However, CMV infection in patients with UC accompanied by toxic megacolon has rarely been reported. Here we report a case of CMV infection of the colon accompanied by toxic megacolon occurring in UC. A 38-year-old woman had been treated with intravenous hydrocortisone, rectal steroid, and central venous alimentation for 6 weeks under the diagnosis of UC. She was transferred to Akita University Hospital because of increasing bloody diarrhea and abdominal pain. Toxic megacolon was identified by examinations on admission, and she underwent a total colectomy. Examination of the surgical specimen showed severe inflammation of the colon. Microscopically, cytomegalic inclusions were observed in and around the endothelial cells in the inflamed submucosal layer. It can be assumed that CMV infection was a secondary, opportunistic invader superimposed on UC, and that it played an important role in altering the clinical course of the patient.

引用

页码：501 / 505

页数：5

共 23 条

[1]

Henson D., Cytomegalovirus inclusion bodies in the gastrointestinal tract, Arch Pathol, 93, pp. 477-482, (1972)

[2]

Simmons R.L., Matas A.J., Rattazzi L.C., Et al., Clinical characteristics of lethal cytomegalovirus infection following renal transplantation, Surgery, 82, pp. 537-546, (1977)

[3]

Goodman Z.D., Boitnott J.K., Yardley J.H., Perforation of the colon associated with cytomegalovirus infection, Dig Dis Sci, 24, pp. 376-380, (1979)

[4]

Spiegel J.S., Schwabe A.D., Disseminated cytomegalovirus infection with gastrointestinal involvement: The role of altered immunity in the elderly, Am J Gastroenterol, 73, pp. 37-44, (1980)

[5]

Wajsman R., Cappell, Biempica L., Et al., Terminal ileitis associated with cytomegalovirus and the acquired immune deficiency syndrome, Am J Gastroenterol, 84, pp. 790-793, (1989)

[6]

Powell R.D., Warner N.E., Levine R.S., Et al., Cytomegalic inclusion disease and ulcerative colitis: Report of a case in a young adult, Am J Med, 30, pp. 334-340, (1961)

[7]

Tamura H., Acute ulcerative colitis associated with cytomegalic inclusion virus, Arch Pathol, 96, pp. 164-167, (1973)

[8]

Keren D.F., Milligan F.D., Strandberg J.D., Et al., Intercurrent cytomegalovirus colitis in a patient with ulcerative colitis, Johns Hopkins Med J, 136, pp. 178-182, (1975)

[9]

Cooper H.S., Raffensperger E.C., Jonas L., Et al., Cytomegalovirus inclusions in patients with ulcerative colitis and toxic dilatation requiring colonic resection, Gastroenterology, 72, pp. 1253-1256, (1977)

[10]

Sidi S., Graham J.H., Razvi S.A., Et al., Cytomegalovirus infection of the colon associated with ulcerative colitis, Arch Surg, 114, pp. 857-859, (1979)

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