Disseminated Cytomegalovirus Infection and Protein Losing Enteropathy as Presenting Feature of Pediatric Patient with Crohn's Disease.
10.5223/pghn.2015.18.1.60
- Author:
Murat CAKIR
1
;
Safak ERSOZ
;
Ulas Emre AKBULUT
Author Information
1. Department of Pediatric Gastroenterology Hepatology and Nutrition, Karadeniz Technical University, Trabzon, Turkey. muratcak@hotmail.com
- Publication Type:Case Report
- Keywords:
Crohn disease;
Cytomegalovirus infections;
Protein-losing enteropathies
- MeSH:
Abdominal Pain;
Agammaglobulinemia;
Blood Cell Count;
Child;
Colitis;
Colon;
Crohn Disease*;
Cytomegalovirus;
Cytomegalovirus Infections*;
Diarrhea;
Edema;
Humans;
Ileum;
Immunoglobulins;
Inclusion Bodies;
Inflammatory Bowel Diseases;
Lower Extremity;
Protein-Losing Enteropathies*;
Serum Albumin;
Ulcer
- From:Pediatric Gastroenterology, Hepatology & Nutrition
2015;18(1):60-65
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report a pediatric patient admitted with abdominal pain, diffuse lower extremity edema and watery diarrhea for two months. Laboratory findings including complete blood count, serum albumin, lipid and immunoglobulin levels were compatible with protein losing enteropathy. Colonoscopic examination revealed diffuse ulcers with smooth raised edge (like "punched out holes") in the colon and terminal ileum. Histopathological examination showed active colitis, ulcerations and inclusion bodies. Immunostaining for cytomegalovirus was positive. Despite supportive management, antiviral therapy, the clinical condition of the patient worsened and developed disseminated cytomegalovirus infection and the patient died. Protein losing enteropathy and disseminated cytomegalovirus infection a presenting of feature in steroid-naive patient with inflammatory bowel disease is very rare. Hypogammaglobulinemia associated with protein losing enteropathy in Crohn's disease may predispose the cytomegalovirus infection in previously healthy children.
