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Transcription

1 **2 The Japanese Society for AIDS Research The Journal of AIDS Research AIDS : CMV CMV AIDS : /1 **1 - CMV HIV : CMV CMV : AIDS HIV +* : ** */ **2 CMV AIDS CT + CMV CMV + CRP AST AIDS LDH /0 2** ml **0 **1 - S - * / mgkg - - / -2* +* CMV CMV CT + CMV : *0* *2+/ +/ 1 - CMV **2 1 + ; ** A B CMV ** 1*

2 The Journal of AIDS Research Vol +* No - **2 HIV S -2 0 SpO 3* CT + + CT WBC + -** / ml TP 042 g/dl RBC Hb 03 +* / ml +/43 g/dl T-Bil AST *40 mg/dl / IU/l Ht 4+ ALT IU/l Plt * / ml LDH -3 IU/l PT-INR +4*/ ggtp 0 IU/l APTT 04- sec ALP 3* IU/l Fibrinogen /* mg/dl BUN /43 mg/dl FDP *4 mg/ml Cre *43 mg/dl D-dimer +04/ ng/ml Na +-* meq/l K 4 meq/l Cl 31 meq/l CRP 42 mg/dl *+ 1+

3 R Morita et al : Cytomegalovirus-induced Ischemic Colitis in a Patient with Acquired Immunodeficiency Syndrome GCV CMV GCV FCV CMV C1 -HRP *** HIV-RNA CMV 20*** copiesml CD ml AaDO b-d Val GCV HIV CMV ABC-TC ; 0** mg CMV -** mg EFV ; 0** mg A B - A CMV Hematoxylineosin ; ** B CMV ** WBC neutro /5** / ml 234* TP Alb /41 g/dl 40 g/dl HBs Ag HBs Ab +04- miu/ml lymph /4* T-Bil *40 mg/dl HBc Ab 0+4- mono 4* AST 0+ IU/l HCV Ab eosino 4* ALT -/ IU/l Candida Ag RBC 01 +* / ml LDH // IU/l b-d glucan 04* pg/ml Hb 242 g/dl ggtp + IU/l aspergillus antigens : *4- c/o Ht /4 ALP +31 IU/l CMVantigenemia (C1-HRP) : +50-/ -15*** Plt +40 +* / ml BUN ++ mg/dl HIV-RNA : 205*** copies/ml PT-INR +4+* Cre *4 mg/dl CD positive lymphocyte : / ml APTT -4 sec Na +-/ meq/l [Blood gas analysis (room air)] Fibrinogen +0+ mg/dl K -41 meq/l ph 14/+1 FDP 14* mg/ml Cl +* meq/l pco 0 mmhg po 0-41 mmhg D-dimer +41- ng/ml CRP *433 mg/dl AaDO /243 mmhg * 1

4 The Journal of AIDS Research Vol +* No - **2 HIV HIV-RNA CD CMV CMV CMV +* / CMV CMV CMV CMV HIVAIDS CD CMV HIV-RNA ++ AIDS CMV CD HIV-RNA CMV S CMV HIV *- 1-

5 R Morita et al : Cytomegalovirus-induced Ischemic Colitis in a Patient with Acquired Immunodeficiency Syndrome CD 0 Beiras A : Cyytomegarovirus colitis mimicking a colonic neoplasm or ischemic colitis years after heart transplantation Tranplantation 00 : +/0 +/0/ +332 Samant JS Namgoong SH Parveen T Katner HP : Cytolate-stage megalovirus vasculitis and mucormycosis coinfection in HIV/AIDS Am J Med Sci --- : + + **1 1 Smith FB Arias JH Elmquist TH Mazzara JT : Micro- + Salzberger B Hartmann P Hanses F Uyanik B Cornely vascular cytomegalovirus endothelialitis of the lung : a OA Wohrmann A Fatkenheur G : Incidence and prog- possible cause of secondary pulmonary hypertension in a nosis of CMV disease in HIV-infected patients before and patient with AIDS Chest ++ : --1-* +332 after introduction of combination antiretrovairal therapy 2 Brannagan TH : Retroviral-associated vasculitis of the Infection -- : -/ -3 **/ nervous system Neurol Clin +/ : Lee CJ Lian JD Chang SW Chou M Tyan YS Wong 3 : AIDS LC Chang HR : Lethal cytomegalovirus ischemic colitis * : -1-- **- presenting with fever of unknown origin Transpl Infect +* Kazory A Ducloux D Coaquette A Manzoni P Chalo- Dis 0 : + +2 ** pini JM : Cytomegalovirus-Associated venous thromboembolism - Siegal DS Hamid N Cunha BA : Cytomegalovirus colitis in renal transplant recipients : a report of 1 mimicking ischemic colitis in an immunocompetent host cases Transplantation 11 : /310*1 ** Heart and Lung - : 3+ 3 **/ ++ Tran HS Moncure M Tarno# M Goodman M Puc MM Joseph M Kenneth O Sambasvia R Michael A : Ischemic colitis secondary to venous thrombosis : A rare presenta- Kroon D Brathwaite CEM Eydelman J Ross SE : Pre- dictors of operative outcome in patients with human imtion of cytomegalovirus vasculitis following renal trans- munodeficiency virus infection and acquired immunoplantation Transplantation 0+ : +0/+ +0/ deficiency syndrome American Journal of Surgery +2* : / Crespo M Arnal F Gomez M Monserrat L Suarez F 2 -- *** Rodriguez J Paniague M Cuesta M Ju# e A Castro- * 1

6 The Journal of AIDS Research Vol +* No - **2 Cytomegalovirus-induced Ischemic Colitis in a Patient with Acquired Immunodeficiency Syndrome Rena M ORITA Satoshi H ASHINO Masahiro O NOZAWA Kaoru K AHATA + + Takeshi K ONDO Masahiro IMAMURA and Masahiro ASAKA + Department of Gastroenterology and Hematology Hokkaido University Graduate School of Medicine Department of Hematology and Oncology Hokkaido University Graduate School of Medicine Objective : We report a surgical case of Cytomegalovirus (CMV)-induced ischemic colitis in a patient with acquired immunodeficiency syndrome (AIDS) Case Report : A /1-year-old woman was referred to another hospital for poor eyesight in March **1 She was diagnosed as having multiple sclerosis and was treated with systemic prednisolone Two weeks later she had sudden abdominal pain and hematochezia and was admitted to another emergency hospital Because her laboratory data and results of colon endoscopy suggested widespread necrosis of colon she underwent an abdominal operation A pathological specimen showed acute vasculitic change and a thrombus in a submucosal vein and there were endothelial cells with intranuclear inclusions typical of CMV infection We comfirmed the diagnosis of CMV-induced ischemic colitis HIV antibody which was analyzed after informed consent had been obtained was positive Conclusion : CMV colitis is a frequent and severe complication in patients with AIDS However CMV-induced ischemic colitis is rare Patients with CMV colitis complain of abdominal pain diarrhea and hematochezia which are usually caused by gastrointestinal inflammation or ulceration CMV-induced ischemic colitis is often fatal Key words : ischemic colitis cytomegalovirus HIV AIDS */ 1/