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Eosinophilic enteritis accompanied by cytomegalovirus disease: a case report
Yuichi Yamaga1, Masahiro Mizuno2,3, Shunji Okae2,4
1Department of Gastroenterology, Mitsubishi Kyoto Hospital, Kyoto, Japan. yyamaga5@orion.ocn.ne.jp.
BMC Gastroenterology
|April 28, 2022
Summary
Eosinophilic enteritis complicated by Cytomegalovirus (CMV) disease in an elderly patient did not respond to steroids. Ganciclovir treatment improved the condition, and azathioprine allowed steroid discontinuation, stabilizing the patient for four years.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Immunology
Background:
- Eosinophilic enteritis is a chronic intestinal inflammation marked by eosinophil infiltration.
- Cytomegalovirus (CMV) can reactivate from latency, causing disease when immune defenses are compromised.
Observation:
- An elderly female presented with diarrhea, hypoalbuminemia, and small intestine edema.
- Histology confirmed eosinophilic enteritis, but steroid treatment was ineffective.
- The patient tested positive for CMV antibodies and had high CMV antigenemia.
Findings:
- Intravenous ganciclovir administration led to clinical improvement.
- Azathioprine facilitated safe steroid tapering, preventing eosinophilic enteritis relapse.
- This combined therapy stabilized the patient for approximately four years.
Implications:
- Highlights the importance of considering CMV co-infection in refractory eosinophilic enteritis.
- Suggests ganciclovir and azathioprine as effective treatment options for CMV-associated eosinophilic enteritis.
- Demonstrates a successful long-term management strategy for a complex case.
