Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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CMV Gastric Ulcers Healed by Supportive Therapy

면역기능정상 거대세포바이러스 위궤양의 항궤양제 치유

  • Lee, Hyoung-Don (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kim, Nam-Hoon (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Lee, Ki-Jun (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Lee, Hyuk (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Jun, Jin-Ho (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Bae, Won-Ki (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kim, Kyung-Ah (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Lee, June-Sung (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine)
  • 이형돈 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 김남훈 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 이기준 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 이혁 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 전진호 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 배원기 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 김경아 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 이준성 (인제대학교 의과대학 일산백병원 내과학교실)
  • Published : 2011.07.30
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Abstract

Cytomegalovirus (CMV) is a potentially important pathogen in an immunocompromised host. CMV infection usually occurs in patients with severe immune deficiency, such as acquired immunodeficiency syndrome, organ transplantation, malignant disease, or immunosuppressive therapy. CMV can cause ulcerations anywhere in the GI tract ranging from the esophagus to the rectum, but the colon is the most susceptible organ in the GI tract. CMV infection rarely occurs but generally causes an asymptomatic or mildly symptomatic acute illness in immunocompetent patients. Some patients with gastrointestinal CMV disease do not require antiviral treatment such as ganciclovir and frequently recover with supportive therapy. Although in immunocompetent patients, antiviral therapy may be needed based on age, chronic illness, or treatment response. We experienced a case of CMV-induced multiple gastric ulcers with severe epigastric pain in an immunocompetent patient who fully recovered with supportive therapy including a proton pump inhibitor.

CMV는 면역기능이 저하된 환자의 주요한 병원체이다. 잠복기 상태에 있던 CMV는 장기 이식이나 신생물 관련 질환, 그리고 사람면역결핍바이러스 감염 등과 같은 면역기능이 저하되는 경우 재활성화된다. 주로 폐, 간 중추신경계, 위장관을 침범하여 심한 감염을 유발하고 이 중 위장관에 감염될때는 식도, 위, 소장 등 전 영역에서 발생할 수 있으며 대장이 가장 흔하다. 면역기능의 저하가 없는 정상인에서도 CMV 감염이 발생한 예가 드물게 보고되고 있다. 면역기능이 정상인 환자에서 CMV의 위장관 감염은 종종 자연히 호전되는 경과를 보이며 보존적인 치료만으로도 치유되는 경우와 ganciclovir의 항바이러스제 치료가 요구되는 경우가 상존한다. 저자들은 면역기능이 정상인 남자에서 CMV에 의해 발생한 다발성 위궤양을 항바이러스제 치료없이 PPI로 치유된 증례를 경험하여 이를 문헌고찰과 함께 보고한다.

Keywords

References

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