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Cytomegalovirus disease in nonimmunocompromised, human immunodeficiency virus-negative adults with chronic kidney disease.
MedLine Citation:
PMID:  23481408     Owner:  NLM     Status:  Publisher    
BACKGROUND/PURPOSE(S): To identify the clinical characteristics of cytomegalovirus (CMV) disease in chronic kidney disease (CKD) patients. METHODS: Patients from two sources were reviewed: (1) a retrospective study of hospitalized patients admitted between January 1990 and February 2009 was performed at a tertiary hospital in Taiwan; (2) the English literature from 1990 to 2009 was reviewed for additional cases, and adults with CKD and histopathologically documented cytomegalovirus disease were included. RESULTS: Seven CKD patients from our hospital and seven from the literature were included. Nine (64.3%) patients were males, and the mean age was 66 years. Histopathologically proven CMV disease was present in the gastrointestinal (GI) tract of 13 (92.9%) and in the skin of one (7.1%) patient. GI symptoms included bleeding (78.6%), abdominal pain (35.7%), and diarrhea (28.6%).The most common comorbidities were diabetes mellitus (7, 50%) and hypertension (8, 57.1%). Thirteen patients had CMV GI disease. The endoscopic gross features of the GI tract lesions included single or multiple ulcers and a large polypoid or uneven surface mass. Of the seven cases with available data, a low body mass index (22.3 ± 1.3 kg/m(2)) and hypoalbuminemia (25 ± 7.0 g/L) were noted. Twelve patients had received ganciclovir or valganciclovir therapy. Five (35.7%) patients died, and the death of two patients was directly related to bowel perforation caused by CMV colitis. CONCLUSION: CMV disease may occur in CKD patients without the presence of overt immunodeficiency. The gastrointestinal tract is the most common site of involvement. Clinicians should be aware of this possibility in CKD patients who have GI symptoms.
Yao-Ming Chen; Yuan-Pin Hung; Chien-Fang Huang; Nan-Yao Lee; Chiung-Yu Chen; Junne-Ming Sung; Chia-Ming Chang; Po-Lin Chen; Ching-Chi Lee; Yi-Hui Wu; Hsiao-Ju Lin; Wen-Chien Ko
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-4
Journal Detail:
Title:  Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi     Volume:  -     ISSN:  1995-9133     ISO Abbreviation:  J Microbiol Immunol Infect     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-3-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100956211     Medline TA:  J Microbiol Immunol Infect     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013. Published by Elsevier B.V.
Department of Internal Medicine, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan.
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