Cytomegalovirus in upper gastrointestinal ulcers

R. N. Murray, Allan L Parker, S. C. Kadakia, E. Ayala, E. M. Martinez

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Cytomegalovirus (CMV), an important cause of severe infections in immunocompromised patients, can cause ulcerations anywhere in the gastrointestinal tract, most commonly stomach and colon. Only a few cases of CMV inclusions in gastrointestinal ulcers have been reported in normal hosts. We undertook a prospective study of the incidence of CMV in gastroduodenal ulcerations in immunocompetent patients. Thirty-eight patients who were referred for evaluation of dyspepsia, hematemesis, melena, guaiac-positive stools, or iron deficiency anemia and who had gastric or duodenal ulcerations without stigmata of recent hemorrhage or visible vessel were enrolled in the study. Six biopsies obtained from the ulcer base and margin were submitted for histologic examination, shell-vial viral cultures, and monoclonal antibody testing. Thirty-two patients had gastric ulcer and six had duodenal bulbar ulcer ranging in size from 8 to 20 mm in diameter. Forty-four percent of patients had been taking aspirin or nonsteroidal antiinflammatory drugs (NSAIDs) within 10 days of ulcer discovery. Evaluation of all biopsies in 38 patients failed to document any evidence of CMV by light microscopy, viral cultures, or monoclonal antibody testing. CMV infection is uncommon in the gastrointestinal tract of immunocompetent patients with gastroduodenal ulcers. Even within areas of previous mucosal injury induced by nonsteroidal drugs, no evidence of CMV 'superinfection' was found. We conclude that CMV infection is not a significant factor in routine peptic or NSAID-induced ulcer disease, and the discovery of CMV inclusions in gastroduodenal ulcerations should lead to a search for an immunocompromised state.

Original languageEnglish (US)
Pages (from-to)198-201
Number of pages4
JournalJournal of Clinical Gastroenterology
Volume19
Issue number3
DOIs
StatePublished - 1994
Externally publishedYes

Fingerprint

Cytomegalovirus
Ulcer
Viral Antibodies
Cytomegalovirus Infections
Gastrointestinal Tract
Stomach
Anti-Inflammatory Agents
Guaiac
Monoclonal Antibodies
Pharmaceutical Preparations
Melena
Biopsy
Hematemesis
Christianity
Superinfection
Iron-Deficiency Anemias
Dyspepsia
Immunocompromised Host
Stomach Ulcer
Duodenal Ulcer

Keywords

  • Aspirin
  • Cytomegalovirus
  • Nonsteroidal antiinflammatory drugs
  • Ulcers, upper gastrointestinal

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Murray, R. N., Parker, A. L., Kadakia, S. C., Ayala, E., & Martinez, E. M. (1994). Cytomegalovirus in upper gastrointestinal ulcers. Journal of Clinical Gastroenterology, 19(3), 198-201. https://doi.org/10.1097/00004836-199410000-00005

Cytomegalovirus in upper gastrointestinal ulcers. / Murray, R. N.; Parker, Allan L; Kadakia, S. C.; Ayala, E.; Martinez, E. M.

In: Journal of Clinical Gastroenterology, Vol. 19, No. 3, 1994, p. 198-201.

Research output: Contribution to journalArticle

Murray, RN, Parker, AL, Kadakia, SC, Ayala, E & Martinez, EM 1994, 'Cytomegalovirus in upper gastrointestinal ulcers', Journal of Clinical Gastroenterology, vol. 19, no. 3, pp. 198-201. https://doi.org/10.1097/00004836-199410000-00005
Murray, R. N. ; Parker, Allan L ; Kadakia, S. C. ; Ayala, E. ; Martinez, E. M. / Cytomegalovirus in upper gastrointestinal ulcers. In: Journal of Clinical Gastroenterology. 1994 ; Vol. 19, No. 3. pp. 198-201.
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