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Protein-losing gastropathy associated with cytomegalovirus infection in a child

Tânia Russo1, Claudia Costa, Conceição Crujo

  • 1Department of Pediatrics, Hospital de Santo André, EPE, Centro Hospitalar Leiria-Pombal, Leiria, Portugal. tania.russo@gmail.com

BMJ Case Reports
|June 28, 2012
PubMed

Insights

Cytomegalovirus (CMV) can cause protein-losing gastropathy in children, presenting as edema and hypoproteinemia. Diagnosis requires endoscopy and biopsy, even without immunodeficiency, as this condition is often benign and self-limited in pediatric cases.

Area of Science:

  • Gastroenterology
  • Pediatrics
  • Virology

Background:

  • Protein-losing gastropathy is uncommon in children and typically benign.
  • The role of cytomegalovirus (CMV) in pediatric protein-losing gastropathy is poorly understood.
  • Limited reports detail the immunological status of affected children.

Observation:

  • An 11-year-old boy presented with generalized edema and hypoproteinemia.
  • Upper endoscopy revealed significant gastric fold hypertrophy and foveolar hyperplasia.
  • Cytomegalovirus was confirmed in gastric tissue via inclusions, immunohistochemistry, and PCR.

Findings:

  • The study documents a case of pediatric protein-losing gastropathy attributed to cytomegalovirus.
  • The patient exhibited no signs of immunodeficiency, ruling out opportunistic infection in an immunocompromised host.
  • Endoscopic findings included marked gastric changes consistent with the condition.

Implications:

  • Protein-losing gastropathy should be considered in the differential diagnosis of pediatric edema and hypoproteinemia.
  • Cytomegalovirus should be investigated as a potential etiological agent in these cases.
  • Endoscopy-based diagnostics are crucial for confirming the diagnosis and guiding management in children.

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