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Predisposition to Cytomegalovirus Infection of the Gastrointestinal Tract
- David O. Arnar, MD; and
- Gunnar Gudmundsson, MD
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TO THE EDITOR:
In a recent, extensive review of gastrointestinal cytomegalovirus disease, Goodgame [1] indicated that this condition can occur in patients with healthy immune systems, although it is more common in immunocompromised hosts. Most reports of this infection in normal hosts lack a thorough immunologic evaluation. We reported a case of cytomegalovirus-associated gastric ulcers in a patient with no detectable immunologic abnormalities [2].
Our patient was a 42-year-old woman who presented with nausea, vomiting, and abdominal pain. Endoscopic examination of the upper gastrointestinal tract showed three gastric ulcers. Biopsy specimens showed cytomegalovirus inclusion bodies. Serologic test results for cytomegalovirus antibody were negative in serum stored 17 months earlier but showed IgM antibodies at the time of her illness. A thorough work-up for immunologic abnormalities (including antibody testing for the human immunodeficiency virus) was negative, as was a similar repeated evaluation 6 months later. The patient recovered and remains in good health almost 5 years later.
David O. Arnar, MD
Gunnar Gudmundsson, MD
University of Iowa Hospitals and Clinics; Iowa City, IA 52242
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
