Gastrointestinal cytomegalovirus disease in renal transplant recipients: a case series

• Published in: Clinical transplantation Vol. 26; no. 2; pp. 345 - 350
• Main Authors: de Andrade, Luís G.M., Rodrigues, Maria A.M., Romeiro, Fernando G., Carvalho, Maria F.C.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.2012; Wiley
• Subjects: Adult; Biological and medical sciences; Cytomegalovirus; Cytomegalovirus Infections - diagnosis; Cytomegalovirus Infections - drug therapy; Cytomegalovirus Infections - mortality; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; gastrointestinal; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - drug therapy; Gastrointestinal Diseases - mortality; Gastrointestinal Diseases - virology; Gastrointestinal tract; Humans; Immunocompromised Host; Infectious diseases; Kidney diseases; Kidney Transplantation; Male; Medical sciences; Middle Aged; Mortality; Opportunistic Infections - diagnosis; Opportunistic Infections - drug therapy; renal transplantation; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Tissue, organ and graft immunology; Viral diseases; Opportunistic infection; Herpesviridae; renal transplantation; Gastrointestinal; Homotransplantation; Betaherpesvirinae; Kidney; Human cytomegalovirus; Infection; Virus; Case study; Medicine; Treatment; Urinary system; cytomegalovirus; Surgery; Gastrointestinal diseases; Viral disease; Graft; Kidney transplantation
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/j.1399-0012.2011.01514.x

de Andrade LGM, Rodrigues MAM, Romeiro FG, Carvalho MFC. Gastrointestinal cytomegalovirus disease in renal transplant recipients: a case series. 
Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01514.x. 
© 2011 John Wiley & Sons A/S. :  The purpose of this article was to report a series of 23 renal transplant recipients with histologically proven and immunohistochemically confirmed cytomegalovirus (CMV) lesions in the gastrointestinal tract (GIT) and to assess the risk factors associated with severe disease/mortality. CMV patients (n = 23) were allocated into two groups: those who died (n = 6) and those considered cured (n = 17). Overall mortality rate was 26% (6/23). Initial symptoms suggestive of lower GIT involvement were observed in all death cases and in 35.3% of those cured (p = 0.01). Enterorrhagia was seen in 83.3% of the patients who died. Death risk increased twofold (RR 2 [1.13–3.52], p = 0.01) when symptoms of lower GIT involvement were initially observed and sixfold when enterrohagia was present (RR 6 [1.1–35.9], p = 0.001). Among death cases, mean time at diagnosis was significantly more distant (2002 ± 2.9 × 2008 ± 1.6, p = 0.04). The difference in mortality rates seen as service practices changed along the years demonstrates the importance of early diagnosis.