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Cytomegalovirus ileocolitis in a rheumatoid arthritis patient: case report and literature review

M. S. Dag, I. H. Turkbeyler, Z. A. Ozturk, B. Kısacık, E. Tutar, A. Kadayıfçı
  • M. S. Dag
    Department of Internal Medicine, School of Medicine, Gaziantep University, Turkey
  • I. H. Turkbeyler
    Department of Internal Medicine, School of Medicine, Gaziantep University, Turkey | turkbeyler@mynet.com
  • Z. A. Ozturk
    Department of Internal Medicine, School of Medicine, Gaziantep University, Turkey
  • B. Kısacık
    Department of Internal Medicine, School of Medicine, Gaziantep University, Turkey
  • E. Tutar
    Department of Internal Medicine, School of Medicine, Gaziantep University, Turkey
  • A. Kadayıfçı
    Department of Internal Medicine, School of Medicine, Gaziantep University, Turkey

Abstract

Rheumatoid arthritis (RA) is an autoimmune, systemic, chronic, inflammatory disease generally treated with various immunosuppressive drugs. Cytomegalovirus (CMV) is an opportunistic, viral infection that is commonly seen in immunosuppressed patients. A sixty-four-year old female diagnosed with RA and treated with immunosuppressive agents was admitted to our rheumatology outpatient service with complaints of diarrhea and abdominal pain, which had lasted longer than four weeks. The patient’s colonoscopy revealed inflamed and ulcerated areas in the colon and in the terminal ileum. A biopsy showed intra-nuclear inclusion particles consistent with CMV. We started an oral valganciclovir therapy in this serum-CMV-polymerase chain reactionpositive patient. The concomitant use of immunosuppressive agents and anti-viral drugs eased the patient’s complaints, and the endoscopic picture improved. Consequently, cytomegalovirus ileocolitis in immunosuppressed patients admitted with severe diarrhea must be considered in the differential diagnosis.

Keywords

Rheumatoid arthritis, Cytomegalovirus, Ileocolitis.

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Submitted: 2014-09-17 21:10:33
Published: 2015-06-30 18:58:03
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Copyright (c) 2015 M. S. Dag, I. H. Turkbeyler, Z. A. Ozturk, B. Kısacık, E. Tutar, A. Kadayıfçı

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