Document Type : original article
Authors
- Tahereh Sadeghi 1
- Mohamadbagher Golkar 2
- Maryam Khalesi 3
- nasrin Moazzen 4
- mahhamad ali kiani 5
- Seyed Ali Jafari 6
- hamidreza kianifar 7
1 Department of Pediatrics, School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Akbar hospital, Mashhad University of Medical Sciences, Mashhad, Iran
2 1- Clinical Research Development Unit of Akbar Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. https://orcid.org/0009-0004-4988-1328
3 2- Associate Professor of Pediatrics Gastroenterology, Department of Pediatrics, School of Medicine, Akbar Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. https://orcid.org/0000-0002-5675-5619
4 3- Assistant Professor of Allergy and Clinical Immunology, Department of Pediatrics, School of Medicine, Allergy Research Center, Akbar Hospital, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. https://orcid.org/0000-0001-8129-
5 5- Professor of Pediatrics Gastroenterology, Department of Pediatrics, School of Medicine, Antimicrobial Resistance Research Center, Basic Sciences Research Institute, Akbar Hospital, Mashhad University of Medical Sciences, Mashhad,
6 6- Associate Professor of Pediatrics Gastroenterology, Department of Pediatrics, School of Medicine, Akbar Hospital, Mashhad University of Medical Sciences, Mashhad, Iran, https://orcid.org/0000-0001-9749-5086
7 7- Professor of Pediatrics Gastroenterology, Department of Pediatrics, School of Medicine, Akbar Hospital, Mashhad University of Medical Sciences, Mashhad. Iran, https://orcid.org/0000-0003-1881-1525
Abstract
Background:This study sought to assess both the clinical manifestations, endoscopic findings, and the underlying etiology, among pediatric cases afflicted by gastrointestinal CMV infection.Methods: This retrospective study encompassed all pediatric patients diagnosed with GI-CMV who were referred to Akbar Children's Hospital in Mashhad, Iran, meeting the study inclusion criteria. The inclusion criteria included all pediatric patients who underwent endoscopic examination. Comprehensive checklists were devised to document patients' clinical presentations, medical histories, and endoscopic findings, utilizing data extracted from patient records and systematically recorded. Statistical analysis was conducted using SPSS software version 23, with statistical significance set at p<0.05.Results: The study comprised seventeen patients, including ten females and seven males, with an overall mortality rate of 17.6%. Notably, 70.6% of the patients tested positive for GI-CMV infection by Endoscopy. Within the subset of patients diagnosed with this infection, 11.76% exhibited gastrointestinal bleeding, while an equal proportion were concomitantly diagnosed with either Crohn's disease or inflammatory bowel disease (IBD). Predominant findings included leukocytosis, diminished red blood cell (RBC) and platelet counts, elevated erythrocyte sedimentation rate (ESR), and abnormal liver function test results in approximately half of the cases. Endoscopic and colonoscopic evaluations revealed various pathological features such as esophagitis, gastric ulcers, antral nodularity, duodenal edema, as well as chronic and acute colitis involving the colon and rectum.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 IBD.
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