Endoscopic features of cytomegalovirus disease of the upper gastrointestinal tract between transplant and non-transplant patients

Background/Aims Cytomegalovirus (CMV) disease in the upper gastrointestinal (UGI) tract frequently occurs in immunocompromised patients. However, data regarding UGI CMV disease in non-transplant patients compared with those in transplant recipients are limited. Therefore, we compared the clinical ch...

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Main Authors: Yuri Kim, Do Hoon Kim, Myeongsook Seo, Hee Kyong Na, Kee Wook Jung, Ji Yong Ahn, Jeong Hoon Lee, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
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Language:English
Published: The Korean Association of Internal Medicine 2025-05-01
Series:The Korean Journal of Internal Medicine
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Online Access:http://kjim.org/upload/kjim-2024-250.pdf
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author Yuri Kim
Do Hoon Kim
Myeongsook Seo
Hee Kyong Na
Kee Wook Jung
Ji Yong Ahn
Jeong Hoon Lee
Kee Don Choi
Ho June Song
Gin Hyug Lee
Hwoon-Yong Jung
author_facet Yuri Kim
Do Hoon Kim
Myeongsook Seo
Hee Kyong Na
Kee Wook Jung
Ji Yong Ahn
Jeong Hoon Lee
Kee Don Choi
Ho June Song
Gin Hyug Lee
Hwoon-Yong Jung
author_sort Yuri Kim
collection DOAJ
description Background/Aims Cytomegalovirus (CMV) disease in the upper gastrointestinal (UGI) tract frequently occurs in immunocompromised patients. However, data regarding UGI CMV disease in non-transplant patients compared with those in transplant recipients are limited. Therefore, we compared the clinical characteristics, endoscopic findings, and outcomes of UGI CMV disease in non-transplant patients with those in transplant recipients. Methods We reviewed the medical records of patients diagnosed with UGI CMV disease between May 1999 and January 2022. UGI CMV disease was defined as symptoms or signs of gastrointestinal disease with typical findings of CMV inclusion body and positive immunochemistry stain or CMV polymerase chain reaction from the endoscopic biopsy specimen. Results Among the 219 eligible patients, 132 (60.3%) were transplant patients. Age, male sex, and Charlson Comorbidity Index were significantly higher in the non-transplant group than in the transplant group. The most common symptoms were pain and odynophagia (43.8%). Transplant recipients more frequently experienced UGI CMV disease in the stomach than non-transplant patients, typically presenting as erosions or mucosal hyperemia. However, non-transplant patients more commonly experienced UGI CMV disease in the esophagus than transplant recipients, typically presenting as ulcers. The transplant group had a significantly higher clinical response than the non-transplant group. Conclusions UGI CMV disease in transplant patients can be present in the stomach in various forms, including ulcers or erosions. In transplant patients suspected of UGI CMV disease, conducting an esophagogastroduodenoscopy with tissue biopsy in any area where even the slightest mucosal abnormality is observed is essential to facilitate a prompt diagnosis.
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spelling doaj-art-fa60f43a35dc4353b3b6bb02022b7d572025-08-20T02:32:18ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482025-05-0140339440310.3904/kjim.2024.250171011Endoscopic features of cytomegalovirus disease of the upper gastrointestinal tract between transplant and non-transplant patientsYuri Kim0Do Hoon Kim1Myeongsook Seo2Hee Kyong Na3Kee Wook Jung4Ji Yong Ahn5Jeong Hoon Lee6Kee Don Choi7Ho June Song8Gin Hyug Lee9Hwoon-Yong Jung10 Division of Gastroenterology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Gastroenterology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaBackground/Aims Cytomegalovirus (CMV) disease in the upper gastrointestinal (UGI) tract frequently occurs in immunocompromised patients. However, data regarding UGI CMV disease in non-transplant patients compared with those in transplant recipients are limited. Therefore, we compared the clinical characteristics, endoscopic findings, and outcomes of UGI CMV disease in non-transplant patients with those in transplant recipients. Methods We reviewed the medical records of patients diagnosed with UGI CMV disease between May 1999 and January 2022. UGI CMV disease was defined as symptoms or signs of gastrointestinal disease with typical findings of CMV inclusion body and positive immunochemistry stain or CMV polymerase chain reaction from the endoscopic biopsy specimen. Results Among the 219 eligible patients, 132 (60.3%) were transplant patients. Age, male sex, and Charlson Comorbidity Index were significantly higher in the non-transplant group than in the transplant group. The most common symptoms were pain and odynophagia (43.8%). Transplant recipients more frequently experienced UGI CMV disease in the stomach than non-transplant patients, typically presenting as erosions or mucosal hyperemia. However, non-transplant patients more commonly experienced UGI CMV disease in the esophagus than transplant recipients, typically presenting as ulcers. The transplant group had a significantly higher clinical response than the non-transplant group. Conclusions UGI CMV disease in transplant patients can be present in the stomach in various forms, including ulcers or erosions. In transplant patients suspected of UGI CMV disease, conducting an esophagogastroduodenoscopy with tissue biopsy in any area where even the slightest mucosal abnormality is observed is essential to facilitate a prompt diagnosis.http://kjim.org/upload/kjim-2024-250.pdfcytomegalovirusendoscopyimmunocompromised hosttransplantationchemotherapy
spellingShingle Yuri Kim
Do Hoon Kim
Myeongsook Seo
Hee Kyong Na
Kee Wook Jung
Ji Yong Ahn
Jeong Hoon Lee
Kee Don Choi
Ho June Song
Gin Hyug Lee
Hwoon-Yong Jung
Endoscopic features of cytomegalovirus disease of the upper gastrointestinal tract between transplant and non-transplant patients
The Korean Journal of Internal Medicine
cytomegalovirus
endoscopy
immunocompromised host
transplantation
chemotherapy
title Endoscopic features of cytomegalovirus disease of the upper gastrointestinal tract between transplant and non-transplant patients
title_full Endoscopic features of cytomegalovirus disease of the upper gastrointestinal tract between transplant and non-transplant patients
title_fullStr Endoscopic features of cytomegalovirus disease of the upper gastrointestinal tract between transplant and non-transplant patients
title_full_unstemmed Endoscopic features of cytomegalovirus disease of the upper gastrointestinal tract between transplant and non-transplant patients
title_short Endoscopic features of cytomegalovirus disease of the upper gastrointestinal tract between transplant and non-transplant patients
title_sort endoscopic features of cytomegalovirus disease of the upper gastrointestinal tract between transplant and non transplant patients
topic cytomegalovirus
endoscopy
immunocompromised host
transplantation
chemotherapy
url http://kjim.org/upload/kjim-2024-250.pdf
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