Korean J Gastrointest Endosc.  2009 Sep;39(3):176-180.

Cytomegalovirus Colitis in an Immunocompetent Patient with Henoch-Schonlein Purpura

• Yoon JY
• Jung SA
• Song HJ
• Kang MJ
• Kim SE
• Shim KN
• Yoo K
• Song DE

Abstract

Most cases of cytomegalovirus (CMV) colitis occur in adults with severe immuno- deficiency. There have been a few reports involving immunocompetent patients. CMV colitis may occur after colonic mucosal injury in immunocompetent patients. Henoch-Schonlein purpura (HSP) is a common systemic vasculitis in childhood. Diagnostic criteria include palpable purpura with at least one other manifestation; abdominal pain, IgA deposition, arthritis or arthralgia, or renal involvement. To best of our knowledge, we describe the first case of CMV colitis in an immunocompetent patient with preceding HSP. A 38-year-old man presented with a 1-day history of abdominal pain, diarrhea and vomiting. Two-years previously, he underwent a right hemicolectomy due to intussusception. Over a 1-month period, palpable purpura was evident on both arms and legs. Colonoscopy revealed multiple, linear geographic ulcerations at an anastomosis opening site with huge ulceration at the small bowel, which was covered with white exudates. Colonoscopic biopsy showed CMV inclusion bodies and skin biopsy revealed leukocytoclastic vasculitis. The patient was successfully treated with gancyclovir and prednisolone.

Keyword

Cytomegalovirus; Henoch-Schonlein purpura

MeSH Terms

Abdominal Pain
Adult
Arm
Arthralgia
Arthritis
Biopsy
Colitis
Colon
Colonoscopy
Cytomegalovirus
Diarrhea
European Continental Ancestry Group
Exudates and Transudates
Ganciclovir
Humans
Immunoglobulin A
Inclusion Bodies
Intussusception
Leg
Purpura
Purpura, Schoenlein-Henoch
Skin
Systemic Vasculitis
Ulcer
Vasculitis
Vasculitis, Leukocytoclastic, Cutaneous
Vomiting
Ganciclovir
Immunoglobulin A
Vasculitis, Leukocytoclastic, Cutaneous