ReviewClinical rheumatology2013
Cytomegalovirus disease of the upper gastrointestinal tract in patients with rheumatic diseases: a case series and literature review.
Review in Clinical rheumatology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 50 citations in OpenAlex.
- Ulcerative Esophagitis Caused by Cytomegalovirus During Infectious Mononucleosis in a Young and Immunocompetent Male Patient-A Case Report.Clinical case reports · 2025Article
- Endoscopic features of cytomegalovirus disease of the upper gastrointestinal tract between transplant and non-transplant patients.The Korean journal of internal medicine · 2025Article
- Hyperacute reactivation of cytomegalovirus-induced gastroduodenitis during remission induction in a young male patient with granulomatosis with polyangiitis: a case report and review of literature.Journal of medical case reports · 2025Review
- Case Report: Giant Oral Ulcers Attributed to Cytomegalovirus Infection in a Patient with AIDS.The American journal of tropical medicine and hygiene · 2023Article
- Clinical significance of cytomegalovirus (CMV) pp65 antigenemia in the prediction of CMV infection during immunosuppressive therapy for rheumatic disease.Rheumatology international · 2023Article
- Emergency gastrointestinal tract operation associated with cytomegalovirus infection.Annals of surgical treatment and research · 2023Article
- Cytomegalovirus-Associated Nephrotic Syndrome in a Patient with Myasthenia Gravis Treated with Azathioprine: A Case Report.The American journal of case reports · 2021Article
- Clinical manifestations, risk factors, and prognostic factors of cytomegalovirus enteritis.Gut pathogens · 2021Article
- Unremitting diarrhoea in a girl diagnosed anti-N-methyl-D-aspartate-receptor encephalitis: A case report.World journal of clinical cases · 2020Article
- Clinical characteristics of cytomegalovirus gastritis: A retrospective study from a tertiary medical center.Medicine · 2020Article
- Severe Bleeding due to Cytomegalovirus Esophagitis in a Patient with Diabetes after Interbody Fusion Surgery.Internal medicine (Tokyo, Japan) · 2019Article
- Reactivation of latent cytomegalovirus infection in patients with rheumatologic disease: a case-control study.Rheumatology international · 2019Article
- Colon perforation due to antigenemia-negative cytomegalovirus gastroenteritis after liver transplantation: A case report and review of literature.World journal of gastroenterology · 2019Review
- Real-time quantitative PCR analysis of endoscopic biopsies for diagnosing CMV gastrointestinal disease in non-HIV immunocompromised patients: a diagnostic accuracy study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2018Article
- Colonic perforation due to severe cytomegalovirus disease in granulomatosis with polyangiitis after immunosuppression.Clinical rheumatology · 2018Review
- Cytomegalovirus Disease of the Upper Gastrointestinal Tract: A 10-Year Retrospective Study.GE Portuguese journal of gastroenterology · 2017Article
- The Folate Cycle As a Cause of Natural Killer Cell Dysfunction and Viral Etiology in Type 1 Diabetes.Frontiers in endocrinology · 2017Article
- Detection of cytomegalovirus in the gastric ulcer of a patient with drug-induced hypersensitivity syndrome.JAAD case reports · 2015Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cytomegalovirus disease of the upper gastrointestinal tract (CMV-UGT) is a rare but significant complication in patients with rheumatic diseases. We reviewed records for January 2004 to December 2012 and investigated the occurrence of CMV-UGT in patients with rheumatic diseases to evaluate clinical characteristics, the value of the CMV antigenemia assay, and the association between immunosuppressive therapy and CMV-UGT. Ten CMV-UGT events (six gastric ulcer, two esophagitis, one gastritis, and one duodenal ulcer) in nine patients (three rheumatoid arthritis, three systemic lupus erythematosus, one dermatomyositis, one systemic sclerosis, and one overlap syndrome) were identified based on pathology. Mean age was 66.5 (range, 53-76) years. The CMV antigenemia assay was negative in five cases (50 %). All ten cases received glucocorticoids and six (60 %) received pulsed glucocorticoids. Mean prednisolone dose was 31.3 (range, 7.5-40) mg/day at diagnosis. Concomitant immunosuppressive agents were used in eight cases (80 %). Considering other published cases, the most common immunosuppressive drug was cyclophosphamide (ten cases; 45 %). Notably, two of our patients who were treated with low-dose glucocorticoids plus other milder immunosuppressive drugs (methotrexate and cyclosporine) also developed CMV-UGT. Life-threatening complications such as massive bleeding or perforated ulcer occurred in two patients. These results suggest that patients receiving intensive immunosuppressive therapy such as high-dose glucocorticoids and cyclophosphamide are at higher risk for developing CMV-UGT. Moreover, CMV-UGT can occur even with low-dose glucocorticoid therapy and relatively mild immunosuppressive agents. The value of the CMV antigenemia assay for predicting CMV-UGT appears to be limited.
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