Document Type : original article
Authors
- Mohamadbagher Golkar 1
- Nasrin Moazzen 2
- Mahhamadali Kiani 3
- Seyed Ali Jafari 3
- Hamidreza Kianifar 3
- Tahereh Sadeghi 4
- Maryam Khalesi 3
1 Clinical Research Development Unit of Akbar Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Department of Allergy and Clinical Immunology, Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Department of Pediatrics Gastroenterology, Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Department of Pediatrics, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
Background: Cytomegalovirus (CMV) is a common viral infection, with gastrointestinal CMV infection primarily seen in individuals with weakened immune systems, impacting the clinical outcomes of affected patients. This study aim to evaluate the clinical manifestations, endoscopic findings, and underlying causes among pediatric cases with gastrointestinal CMV infection.
Methods: This retrospective study included all pediatric patients diagnosed with GI-CMV who were referred to Akbar Children's Hospital in Mashhad, Iran, and met the study’s criteria. The criteria included pediatric patients who underwent endoscopic examinations. Comprehensive checklists were used to document symptoms, clinical presentations, medical histories, and endoscopic findings, with data extracted from patient records. Statistical analysis was performed using SPSS software version 23, with statistical significance set at p < 0.05.
Results: In a study of 17 patients initially admitted with a probable diagnosis of CMV, 12 (70.6%) were confirmed to have CMV during follow-up. The group consisted of 9 girls (75%) and 3 boys (25%), with a mean age of 42.75 months (SD ± 31.95). Most patients (83.3%) were discharged with partial recovery, and CMV infection was confirmed in 70.6% of cases. Pathology revealed that 75% had gastric involvement. The most common initial symptom was bloody vomiting (26%), followed by fever and diarrhea (13%). Ganciclovir was administered to all patients, and 8.33% received Prednisolone as well. Most patients exhibited elevated white blood cell counts, and liver enzymes and albumin levels were also impaired.
Conclusion: Symptoms of CMV colitis tend to be nonspecific and can manifest across a spectrum ranging from mild to severe presentations. Notably, CMV-positive patients are predisposed to more severe forms of colitis, with prolonged hospitalizations and concomitant febrile episodes frequently noted in cases of CMV colitis associated with underlying inflammatory bowel disease (IBD).
Keywords
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