Clinical Characteristics of Cytomegalovirus Disease of the Upper Gastrointestinal Tract: A 10-Year Multicenter Retrospective Study
Objectives Gastrointestinal cytomegalovirus (CMV) disease is a major contributor to mortality in immunocompromised patients. Few studies have discussed upper gastrointestinal CMV (UGICMV) disease in immunocompetent patients. We compared the clinical outcomes of UGI-CMV between immunocompromised and...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Yong Chan Lee
2023-12-01
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| Series: | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
| Subjects: | |
| Online Access: | http://helicojournal.org/upload/pdf/kjhugr-2023-0054.pdf |
| _version_ | 1827581037066059776 |
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| author | Ga-Ram You Seon-Young Park Hye-Su You Seung-Young Seo Sung-Kyun Yim Byung-Chul Jin Jung-In Lee Young-Dae Kim Suck-Chei Choi Chan-Guk Park Wan-Sik Lee |
| author_facet | Ga-Ram You Seon-Young Park Hye-Su You Seung-Young Seo Sung-Kyun Yim Byung-Chul Jin Jung-In Lee Young-Dae Kim Suck-Chei Choi Chan-Guk Park Wan-Sik Lee |
| author_sort | Ga-Ram You |
| collection | DOAJ |
| description | Objectives Gastrointestinal cytomegalovirus (CMV) disease is a major contributor to mortality in immunocompromised patients. Few studies have discussed upper gastrointestinal CMV (UGICMV) disease in immunocompetent patients. We compared the clinical outcomes of UGI-CMV between immunocompromised and immunocompetent patients. Methods This retrospective study included patients with UGI-CMV disease from five tertiary hospitals across Korea (2010– 2022). Patients’ clinical data and outcomes were recorded. Results UGI-CMV was diagnosed in 54 patients; 27 (50.0%) had esophageal, 24 (44.4%) had gastric, and 3 patients (5.6%) had duodenal involvement. Patients’ median age was 64 years (interquartile range 53–75 years), and the most common comorbidities included hypertension (57.4%) and diabetes (38.9%). The predominant symptom was abdominal pain (46.3%), and the most common endoscopic finding was ulcers (70.4%). Antiviral treatment was administered to 31 patients, and 23 patients underwent observation without treatment. We investigated 32 immunocompromised (59.3%) and 22 immunocompetent (40.7%) patients and observed no intergroup differences in comorbidities and in laboratory and endoscopic findings. Immunocompromised patients had longer length of hospitalization (median 46.2 days vs. 20.0 days, p=0.001). However, treatment outcomes, including the need for intensive care unit admission and mortality did not significantly differ. The overall mortality rate was 13.0%; one patient from the immunocompromised group died of UGI-CMV disease. The treatment success rate was higher in immunocompromised patients who received antiviral therapy (p=0.011). Conclusions UGI-CMV disease is not uncommon in immunocompetent patients, although symptoms are milder than those in immunocompromised patients. Our findings emphasize the importance of clinical vigilance for accurate diagnosis of CMV infection, particularly in susceptible symptomatic patients and highlight the need for active antiviral treatment for management of immunocompromised patients. |
| first_indexed | 2024-03-08T22:29:42Z |
| format | Article |
| id | doaj.art-be71dc8135e244d6ad38ea73b9361749 |
| institution | Directory Open Access Journal |
| issn | 1738-3331 |
| language | English |
| last_indexed | 2024-03-08T22:29:42Z |
| publishDate | 2023-12-01 |
| publisher | Yong Chan Lee |
| record_format | Article |
| series | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
| spelling | doaj.art-be71dc8135e244d6ad38ea73b93617492023-12-18T07:11:45ZengYong Chan LeeThe Korean Journal of Helicobacter and Upper Gastrointestinal Research1738-33312023-12-0123429430110.7704/kjhugr.2023.0054807Clinical Characteristics of Cytomegalovirus Disease of the Upper Gastrointestinal Tract: A 10-Year Multicenter Retrospective StudyGa-Ram You0Seon-Young Park1Hye-Su You2Seung-Young Seo3Sung-Kyun Yim4Byung-Chul Jin5Jung-In Lee6Young-Dae Kim7Suck-Chei Choi8Chan-Guk Park9Wan-Sik Lee10 Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, Korea Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, Korea Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, Korea Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea Department of Internal Medicine, Wonkwang University Hospital, Iksan, Korea Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, KoreaObjectives Gastrointestinal cytomegalovirus (CMV) disease is a major contributor to mortality in immunocompromised patients. Few studies have discussed upper gastrointestinal CMV (UGICMV) disease in immunocompetent patients. We compared the clinical outcomes of UGI-CMV between immunocompromised and immunocompetent patients. Methods This retrospective study included patients with UGI-CMV disease from five tertiary hospitals across Korea (2010– 2022). Patients’ clinical data and outcomes were recorded. Results UGI-CMV was diagnosed in 54 patients; 27 (50.0%) had esophageal, 24 (44.4%) had gastric, and 3 patients (5.6%) had duodenal involvement. Patients’ median age was 64 years (interquartile range 53–75 years), and the most common comorbidities included hypertension (57.4%) and diabetes (38.9%). The predominant symptom was abdominal pain (46.3%), and the most common endoscopic finding was ulcers (70.4%). Antiviral treatment was administered to 31 patients, and 23 patients underwent observation without treatment. We investigated 32 immunocompromised (59.3%) and 22 immunocompetent (40.7%) patients and observed no intergroup differences in comorbidities and in laboratory and endoscopic findings. Immunocompromised patients had longer length of hospitalization (median 46.2 days vs. 20.0 days, p=0.001). However, treatment outcomes, including the need for intensive care unit admission and mortality did not significantly differ. The overall mortality rate was 13.0%; one patient from the immunocompromised group died of UGI-CMV disease. The treatment success rate was higher in immunocompromised patients who received antiviral therapy (p=0.011). Conclusions UGI-CMV disease is not uncommon in immunocompetent patients, although symptoms are milder than those in immunocompromised patients. Our findings emphasize the importance of clinical vigilance for accurate diagnosis of CMV infection, particularly in susceptible symptomatic patients and highlight the need for active antiviral treatment for management of immunocompromised patients.http://helicojournal.org/upload/pdf/kjhugr-2023-0054.pdfcytomegalovirusimmunocompromisedimmunocompetentupper gastrointestinal tract |
| spellingShingle | Ga-Ram You Seon-Young Park Hye-Su You Seung-Young Seo Sung-Kyun Yim Byung-Chul Jin Jung-In Lee Young-Dae Kim Suck-Chei Choi Chan-Guk Park Wan-Sik Lee Clinical Characteristics of Cytomegalovirus Disease of the Upper Gastrointestinal Tract: A 10-Year Multicenter Retrospective Study The Korean Journal of Helicobacter and Upper Gastrointestinal Research cytomegalovirus immunocompromised immunocompetent upper gastrointestinal tract |
| title | Clinical Characteristics of Cytomegalovirus Disease of the Upper Gastrointestinal Tract: A 10-Year Multicenter Retrospective Study |
| title_full | Clinical Characteristics of Cytomegalovirus Disease of the Upper Gastrointestinal Tract: A 10-Year Multicenter Retrospective Study |
| title_fullStr | Clinical Characteristics of Cytomegalovirus Disease of the Upper Gastrointestinal Tract: A 10-Year Multicenter Retrospective Study |
| title_full_unstemmed | Clinical Characteristics of Cytomegalovirus Disease of the Upper Gastrointestinal Tract: A 10-Year Multicenter Retrospective Study |
| title_short | Clinical Characteristics of Cytomegalovirus Disease of the Upper Gastrointestinal Tract: A 10-Year Multicenter Retrospective Study |
| title_sort | clinical characteristics of cytomegalovirus disease of the upper gastrointestinal tract a 10 year multicenter retrospective study |
| topic | cytomegalovirus immunocompromised immunocompetent upper gastrointestinal tract |
| url | http://helicojournal.org/upload/pdf/kjhugr-2023-0054.pdf |
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