Volume 78 - 2015 - Fasc.2 - Letters
CMV gastritis in the immunocompetent host
We report a case of CMV gastritis in a 78 year old immunocompetent male with a blank medical history. He presented with symptoms of anorexia, nausea, mild epi- gastric discomfort and a weight loss of three kilograms. The clinical examination was unremarkable. Blood analysis showed a reactive lymphocytosis with mild elevation of liver enzymes (AST 41 U/L [< 37 U/L], ALT 57 U/L [< 41 U/L], LDH 673 U/L [< 530 U/L]) and C-reactive protein (6 mg/L [< 5 mg/L]). Abdominal ul- trasound was normal. Gastroscopic examination revealed a diffuse gastritis with erosions and multiple, elevated ulcerations with a centrally localised crater. On patho- logical examination an active and focal erosive gastritis was documented. Numerous cells exhibited nuclear in- clusions suggesting CMV gastritis (Fig. 1). Helicobacter pylori testing was positive. IgM anti-CMV and IgG anti- CMV serum antibodies were positive, with low IgG avidity suggesting a recent infection. HIV serology was negative. The patient was treated with proton pump in- hibitors and made a full recovery.
Retrograde dilation of a complex radiation-induced esophageal stricture through percutaneous gastrostomy
Upper esophageal strictures occur in approximately 3-4% of pa- tients who receive radiotherapy for head and neck cancers. The standart initial treatment is dilation by using bougie or through- the-scope balloon dilators. Endoscopic treatment requires the pas- sage of a guidewire through the stricture which cannot be accom- plished in some of the patients with complex strictures. Retrograde dilation of esophageal strictures through a mature percutaneous gastrostomy tract have been reported in a limited number of cases and small case series up to date and can be considered as a rescue treatment before considering surgery in such patients. Herein we report retrograde dilatation of a radiation-induced complex esoph- ageal stricture through the percutaneous gastrostomy tract in a patient with operated larynx cancer. (Acta gastroenterol. belg., 2015, 78, 246-247).
Characteristic imaging findings of duodenal perforation
Two patients were admitted to emergency room with complaint of abdominal pain with abrupt onset and retroperitoneal free air was detected in pararenal area on CT. In this paper, characteristic CT findings of patients diagnosed with duodenal perforation are presented under the light of literature data. (Acta gastroenterol. belg., 2015, 78, 248-249).
Leukoclastic vasculitis extending from esophagus to terminal ileum
Leucocytoclastic vasculitis (LCV) is commonly presented as a skin disease by affecting the small vessels of targeted area. Contain- ing loops of vessels with end- capillaries makes the small intestine villus potantially target area of LcV, when obstructed with immune complexes. (Acta gastroenterol. belg., 2015, 78, 250-251).
Splenic abscess in ulcerative colitis under anti tumor necrosis factor treatment
Splenic abscess are rare conditions. Since morbidity and mortal- ity rates are high, immediate diagnosis should be required. Here we presented an ulcerative colitis patients who develops splenic abscess under anti tumor necrosis factor treatment. (Acta gastroenterol. belg., 2015, 78, 252).
Black esophagus and duodenal perforation : more than an incidental association
Black esophagus has an estimated incidence ranging from 0.01% to 0.28% in large endoscopy series (1). It is characterized by a circumferential black colored necrotic esophageal mucosa with a predilection to the distal esophagus and turning sharply to normal at the gastro- esophageal junction. The etiology includes a combined effect of ischemic injury, impaired esophageal mucosal defense systems, and backflow injury from gastric con- tents. Herein we report a patient with black esophagus and perforated duodenal ulcer suggesting that the com- mon blood supply of the two entities makes them etio- logically related.
Hepatitis B resolution after autologous Bone Marrow Transplantation
Hepatitis B (HBV) reactivation after receiving cyto- toxic chemotherapy (CT), immunosuppressive therapy or after bone marrow transplantation (BMT) is a com- mon and serious problem, which can lead to hepatitis, hepatic failure and even death (1,2).
Although HBV has uncertain viral kinetics in immu- nosuppressive patients, HBsAg loss or seroconversion is not an expected result. Herein, for the first time, we describe HBV resolved patient immediately after autolo- gous BMT.
