위, 십이지장 및 대장을 동시에 침범한 거대세포바이러스 위장관 감염 1예
A Case of Cytomegalovirus Infection associated with Simultaneous Gastric, Duodenal and Colonic Ulcers
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거대세포바이러스(cytomegalovirus, CMV) 위장관 감염은 매우 드물게 면역이 정상인 사람에서도 발생하지만, 임상적인 증상을 나타내는 경우는 대부분 면역 기능이 저하된 환자에서 발생하며 기회감염의 일종이다. 위장관 감염의 경우 구강에서 항문에 이르기까지 소화관의 어느 부위에나 생길 수 있으나, 대장 및 위가 감염되는 경우가 흔하며 소장 침범은 드문 것으로 알려져 있다. 최근 국내에서도 장기이식, 혈액 종양, 면역억제제나 항암제 투여가 늘어남에 따라 거대세포바이러스 감염 발생빈도도 증가되고 있으나 위와 대장을 동시에 침범하는 경우는 매우 드물어 국내에서는 1예의 보고만 있을 뿐이며 위, 십이지장 및 대장을 동시에 침범한 경우는 아직 국내에서 보고된 바가 없다. 저자들은 신장 이식 후 면역 억제제를 투여 받고 있는 환자에서 위, 십이지장, 대장을 동시 침범한 거대세포바이러스 위장관 감염을 경험하였기에 문헌 고찰과 함께 보고하는 바이다.
Abstract
Although cytomegalovirus (CMV) infection of the gastrointestinal tract can occur in persons with normal immune function, it almost exclusively affects the immunocompromised host such as transplant recipients and AIDS patients, and it can cause significant clinical illness. CMV remains the single most important pathogen that affects solid organ transplant recipients. While CMV can affect any segment of the gastrointestinal tract, the colon is the most common site of infection, and this is followed by the upper gastrointestinal tract. However, CMV infection associated with simultaneous gastric and colonic ulcer is very rare and this has been reported in only one case, and a case of simultaneous gastric, duodenal and colonic ulcer associated with CMV infection has not yet been reported in Korea. We report here on a case of simultaneous gastric, duodenal and colonic ulcer associated with CMV infection that showed the characteristic histologic findings seen for CMV infection in renal transplant recipients. (Korean J Gastrointest Endosc 2006;32:42-47)
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