Cytomegalovirus Enterocolitis in a Patient Treated with Methylprednisolone for Amiodarone Hypersensitivity Pneumonitis

Cytomegalovirus (CMV) is a common cause of infection in immunocompromised individuals, such as patients with hematological malignancies or AIDS, but can also occur in patients with other acquired immunodeficiencies. In tissue-invasive diseases, CMV diagnosis requires CMV DNA in the plasma and the hi...

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Main Authors: Darinka Purg, Marko Hojnik, Nika Aleksandra Kravos Tramšek
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/23/2633
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author Darinka Purg
Marko Hojnik
Nika Aleksandra Kravos Tramšek
author_facet Darinka Purg
Marko Hojnik
Nika Aleksandra Kravos Tramšek
author_sort Darinka Purg
collection DOAJ
description Cytomegalovirus (CMV) is a common cause of infection in immunocompromised individuals, such as patients with hematological malignancies or AIDS, but can also occur in patients with other acquired immunodeficiencies. In tissue-invasive diseases, CMV diagnosis requires CMV DNA in the plasma and the histological confirmation of CMV in a tissue or organ. Evidence of CMV colitis requires a characteristic endoscopic picture with ulcers with a well-defined, convex appearance and CMV viral inclusions in the form of an “owl’s eye” on mucosal sections stained with hematoxylin and eosin. CMV-specific immunohistochemistry is the gold standard for identifying CMV in tissue biopsies. It is important to consider a CMV infection in the diagnostic process, as it may delay the diagnosis and the treatment. We present the case of a 78-year-old patient with amiodarone interstitial lung disease who was treated with methylprednisolone. Two weeks after the start of his treatment, he was admitted to the hospital for acute gastroenterocolitis and Addisonian crisis. An examination had confirmed a tissue-invasive CMV disease. He was treated with valganciclovir for a total of six weeks. After the completion of treatment, the patient showed no clinical signs of CMV infection, and both laboratory and histological examinations revealed no residual CMV disease. Tissue-invasive CMV disease can occur in patients with acquired immunodeficiency, which may result from various causes, including glucocorticoid treatment.
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spelling doaj-art-7ea863a6d4e6413f9a93992c806528bc2025-08-20T02:50:18ZengMDPI AGDiagnostics2075-44182024-11-011423263310.3390/diagnostics14232633Cytomegalovirus Enterocolitis in a Patient Treated with Methylprednisolone for Amiodarone Hypersensitivity PneumonitisDarinka Purg0Marko Hojnik1Nika Aleksandra Kravos Tramšek2Department of Gastroenterology, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000 Maribor, SloveniaDepartment of Pathology, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000 Maribor, SloveniaDepartment of Endocrinology and Diabetology, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000 Maribor, SloveniaCytomegalovirus (CMV) is a common cause of infection in immunocompromised individuals, such as patients with hematological malignancies or AIDS, but can also occur in patients with other acquired immunodeficiencies. In tissue-invasive diseases, CMV diagnosis requires CMV DNA in the plasma and the histological confirmation of CMV in a tissue or organ. Evidence of CMV colitis requires a characteristic endoscopic picture with ulcers with a well-defined, convex appearance and CMV viral inclusions in the form of an “owl’s eye” on mucosal sections stained with hematoxylin and eosin. CMV-specific immunohistochemistry is the gold standard for identifying CMV in tissue biopsies. It is important to consider a CMV infection in the diagnostic process, as it may delay the diagnosis and the treatment. We present the case of a 78-year-old patient with amiodarone interstitial lung disease who was treated with methylprednisolone. Two weeks after the start of his treatment, he was admitted to the hospital for acute gastroenterocolitis and Addisonian crisis. An examination had confirmed a tissue-invasive CMV disease. He was treated with valganciclovir for a total of six weeks. After the completion of treatment, the patient showed no clinical signs of CMV infection, and both laboratory and histological examinations revealed no residual CMV disease. Tissue-invasive CMV disease can occur in patients with acquired immunodeficiency, which may result from various causes, including glucocorticoid treatment.https://www.mdpi.com/2075-4418/14/23/2633cytomegalovirus enterocolitisimmunodeficiencyamiodarone pneumonitismethylprednisolone
spellingShingle Darinka Purg
Marko Hojnik
Nika Aleksandra Kravos Tramšek
Cytomegalovirus Enterocolitis in a Patient Treated with Methylprednisolone for Amiodarone Hypersensitivity Pneumonitis
Diagnostics
cytomegalovirus enterocolitis
immunodeficiency
amiodarone pneumonitis
methylprednisolone
title Cytomegalovirus Enterocolitis in a Patient Treated with Methylprednisolone for Amiodarone Hypersensitivity Pneumonitis
title_full Cytomegalovirus Enterocolitis in a Patient Treated with Methylprednisolone for Amiodarone Hypersensitivity Pneumonitis
title_fullStr Cytomegalovirus Enterocolitis in a Patient Treated with Methylprednisolone for Amiodarone Hypersensitivity Pneumonitis
title_full_unstemmed Cytomegalovirus Enterocolitis in a Patient Treated with Methylprednisolone for Amiodarone Hypersensitivity Pneumonitis
title_short Cytomegalovirus Enterocolitis in a Patient Treated with Methylprednisolone for Amiodarone Hypersensitivity Pneumonitis
title_sort cytomegalovirus enterocolitis in a patient treated with methylprednisolone for amiodarone hypersensitivity pneumonitis
topic cytomegalovirus enterocolitis
immunodeficiency
amiodarone pneumonitis
methylprednisolone
url https://www.mdpi.com/2075-4418/14/23/2633
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AT markohojnik cytomegalovirusenterocolitisinapatienttreatedwithmethylprednisoloneforamiodaronehypersensitivitypneumonitis
AT nikaaleksandrakravostramsek cytomegalovirusenterocolitisinapatienttreatedwithmethylprednisoloneforamiodaronehypersensitivitypneumonitis