Kakugawa Y, Kami M, Matsuda T, Saito Y, Kim SW, Fukuda T, Mori SI, Shimoda T, Tanosaki R, Saito D. Endoscopic diagnosis of cytomegalovirus gastritis after allogeneic hematopoietic stem cell transplantation. World J Gastroenterol 2010; 16(23): 2907-2912 [PMID: 20556837 DOI: 10.3748/wjg.v16.i23.2907]
Corresponding Author of This Article
Yasuo Kakugawa, MD, Division of Endoscopy, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. yakakuga@ncc.go.jp
Article-Type of This Article
Brief Article
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Yasuo Kakugawa, Takahisa Matsuda, Yutaka Saito, Daizo Saito, Division of Endoscopy, National Cancer Center Hospital, Tokyo 104-0045, Japan
Masahiro Kami, Division of Exploratory Research, Institute of Medical Science, University of Tokyo, Tokyo 108-0071, Japan
Sung-Won Kim, Takahiro Fukuda, Shin-ichiro Mori, Ryuji Tanosaki, Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo 104-0045, Japan
Tadakazu Shimoda, Clinical Laboratory Division, National Cancer Center Hospital, Tokyo 104-0045, Japan
Author contributions: Kakugawa Y participated in the design of the study, data acquisition and interpretation, performed endoscopic examinations, and wrote the first draft of the manuscript; Kami M managed the therapy of patients, participated in the design of the study, and contributed to the writing of the manuscript; Matsuda T and Saito Y performed endoscopic examinations, and contributed to the writing of the manuscript; Kim SW, Fukuda T, Mori S and Tanosaki R managed the therapy of patients, and contributed to the writing of the manuscript; Shimoda T made the pathological diagnosis and contributed to the writing of the manuscript; Saito D participated in the design of the study and contributed to the writing of the manuscript; all authors read and approved the submitted version of the manuscript.
Correspondence to: Yasuo Kakugawa, MD, Division of Endoscopy, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. yakakuga@ncc.go.jp
Telephone: +81-3-35422511 Fax: +81-3-35423815
Received: March 19, 2010 Revised: April 6, 2010 Accepted: April 13, 2010 Published online: June 21, 2010
Abstract
AIM: To clarify the endoscopic and clinical findings of cytomegalovirus (CMV) gastritis after allogeneic hematopoietic stem cell transplantation (allo-SCT).
METHODS: Between 1999 and 2005, 523 patients underwent allo-SCT at our hospital, and 115 of these patients with gastrointestinal symptoms underwent esophagogastroduodenoscopy.
RESULTS: CMV gastritis was diagnosed pathologically in seven patients (1.3%) with the other 108 patients serving as controls. Six of the seven patients developed positive CMV antigenemia, and five complained of abdominal pain. Development of abdominal pain preceded CMV antigenemia in four of the five patients. Endoscopic examination showed oozing (n = 2), erosion (n = 6), and redness (n = 5) in the seven patients with CMV gastritis, while the control patients showed oozing (n = 3), erosion (n = 24), and redness (n = 100). Erosion and oozing were more frequently documented in patients with CMV gastritis compared with the controls, and the differences were statistically significant (P = 0.0012 and 0.029, respectively). CMV inclusion bodies were documented in 12 of 14 biopsy specimens obtained from erosive lesions, while they were identified in 4 of 15 biopsy specimens obtained from lesions other than erosions (P = 0.0025).
CONCLUSION: This study suggests that erosion and oozing, as well as abdominal pain, are useful indicators in the diagnosis of CMV gastritis following allo-SCT.
