A Pediatric Case with CMV Gastroenteritis after Donor Leukocyte Infusion

Ae Kyung Song; Hee Jun Kim; Hyun Joo Jung; Jun Eun Park; In Ho Jeong; Joon Seong Park; Hugh Chul Kim

doi:10.5045/kjh.2005.40.3.197

Journal List > Korean J Hematol > v.40(3) > 1032631

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Song, Kim, Jung, Park, Jeong, Park, and Kim: A Pediatric Case with CMV Gastroenteritis after Donor Leukocyte Infusion

Case Report

Korean J Hematol 2005;40(3):197-200.

Published online: 21 September 2005

DOI: https://doi.org/10.5045/kjh.2005.40.3.197

A Pediatric Case with CMV Gastroenteritis after Donor Leukocyte Infusion

Ae Kyung Song, M.D.¹, Hee Jun Kim, M.D.¹, Hyun Joo Jung, M.D.¹, Jun Eun Park, M.D.¹, In Ho Jeong, M.D.², Joon Seong Park, M.D.³, Hugh Chul Kim, M.D.³

¹Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea

²Department of Surgery, Ajou University School of Medicine, Suwon, Korea

³Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea

Correspondence to: Jun Eun Park, M.D. Department of Pediatrics, Ajou University School of Medicine 5 Woncheon-dong, Yeongtong-gu, Suwon 442-749, Korea Tel: +82-31-219-5168, Fax: +82-31-219-5169 E-mail: pedpje@ajou.ac.kr

Received 3 August 2005 Revised 12 September 2005 Accepted 12 September 2005

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

There haves been few reports of cytomegalovirus (CMV) gastroenteritis following allogeneic stem cell transplantation, especially in pediatric cases. Herein, we report a case of CMV gastroenteritis in a 10-year-old boy with relapsed juvenile myelomonocytic leukemia who had undergone a donor leukocyte infusion. He presented with a skin rash, diarrhea and abdominal pain following a donor leukocyte infusion. Cramping abdominal pain persisted, even after treatment of the acute graft-versus-host disease. Therefore, gastroduodenoscopy and a gastric mucosal biopsy were performed, after which CMV gastroenteritis was diagnosed. The boy recovered after treatment with ganciclovir and intravenous immunoglobulin.

Keywords: CMV gastroenteritis, GVHD, Donor leukocyte infusion

REFERENCES

1). McDonald GB, Shulman HM, Sullivan KM, Spencer GD. Intestinal and hepatic complications of human bone marrow transplantation. Part II. Gastroenterology. 1986; 90:770–84.

2). Stagno S. Cytomegalovirus. Behrman RE, Klieg-man RM, Jenson HB, editors. Nelson textbook of pediatrics. 17th ed.Philadelphia: Saunders Co;2006. p. 1066–9.

3). Winston DJ, Ho WG, Champlin RE. Cytomegalovirus infections after allogeneic bone marrow transplantation. Rev Infect Dis. 1990; 7(12 Suppl):S776–92.

4). Kim YK, Kim DW. Seroepidemiology of human cytomegalovirus in healthy adults measured by means of the anticomplement immunofluorescence technique. Korean J Infect Dis. 1992; 24:87–92.

5). Wingard JR, Chen DY, Burns WH, et al. Cytomegalovirus infection after autologous bone marrow transplantation with comparison to infection after allogeneic bone marrow transplantation. Blood. 1988; 71:1432–7.

6). Miller W, Flynn P, McCullough J, et al. Cytomegalovirus infection after bone marrow transplantation: an association with acute graft-v-host disease. Blood. 1986; 67:1162–7.

7). Castagnola E, Cappelli B, Erba D, Rabagliati A, La-mino E, Dini G. Cytomegalovirus infection after bone marrow transplantation in children. Hum Immunol. 2004; 65:416–22.

8). van Burik JA, Lawatsch EJ, DeFor TE, Weisdorf DJ. Cytomegalovirus enteritis among hematopoietic stem cell transplant recipients. Biol Blood Marrow Transplant. 2001; 7:674–9.

9). Kim SC, Hahn JS, Chong SY, et al. Cytomegalovirus infection in stem cell transplantation. Korean J Hematol. 1997; 32:388–97.

10). Choi SJ, Lee JH, Lee JH, et al. Treatment of relapsed acute lymphoblastic leukemia after allogeneic bone marrow transplantation with chemotherapy followed by G-CSF-primed donor leukocyte infusion: a prospective study. Bone Marrow Transplant. 2005; 36:163–9.

11). Schulenburg A, Turetschek K, Wrba F, et al. Early and late gastrointestinal complications after myeloablative and nonmyeloablative allogeneic stem cell transplantation. Ann Hematol. 2004; 83:101–6.

12). Goodgame RW. Gastrointestinal cytomegalovirus disease. Ann Intern Med. 1993; 119:924–35.

13). Spencer GD, Hackman RC, McDonald GB, et al. A prospective study of unexplained nausea and vomiting after marrow transplantation. Transplantation. 1986; 42:602–7.

14). Einsele H, Ehninger G, Hebart H, et al. Incidence of local CMV infection and acute intestinal GVHD in marrow transplant recipients with severe diarrhea. Bone Marrow Transplant. 1994; 14:955–63.

Fig. 1.

Gastroduodenoscopic finding. The duodenal mucosa showed multiple erosions with patchy hyperemia.

Fig. 2.

The brownish-red cytomegalic cells (arrowed) showed the positive reactivity in both cytoplasm and nucleus by immunoperoxidase staining for cytomegalovirus (× 100).

TOOLS

Similar articles