Esophageal and gastric ulceration due to synchronous herpes simplex virus, cytomegalovirus and Epstein-Barr virus infection

• Type: Another Publication in an International Scientific Journal
• Date: 2016

Authors

Peixoto, A (Author) Other; João Santos-Antunes (Author) FMUP; Silva, M (Author) Other; Macedo G (Author) FMUP

Journal

Title: Acta Gastro-Enterologica Belgica

Vol. 79

Pages: 271-272

ISSN: 0001-5644

Publisher: ACTA MEDICA BELGICA

Indexing

ISI Web of Knowledge - 2 Citations

Scopus - 3 Citations

Other information

Authenticus ID: P-00K-SBA

Abstract (EN): The authors report the case of a man of 71 years-old, with a previous history of type 2 diabetes mellitus, hypertension, and renal transplantation in 2013 due to chronic kidney disease. He was under immunosuppression with prednisolone, mycophenolate mofetil and tacrolimus. The patient was admitted by worsening of his health status lasting for one month, with progressive asthenia, anorexia weight loss, and marked backache with movement limitation. Analytically he presented with microcytic anemia de novo ( hemoglobin 9.6 g/dL), hypoalbuminemia and a slight increase of liver tests. Initially a thoraco-abdominal computerized tomography was performed and revealed the presence of multiple nodules in the liver parenchyma, suggestive of metastases. In this context it was decided to carry out endoscopic work-up for malignancy screening. The upper endoscopy showed two superficial and longitudinal ulcers in the distal esophagus and in the gastric antrum there were two other larger ulcers with regular edges ( Figs. 1 and 2). Histological evaluation revealed the presence of morphological findings compatible with ulcerated lesions ( Fig. 3), with immunohistochemical analysis inconclusive for cytomegalovirus ( CMV), while the evaluation by molecular biology ( polymerase chain reaction -PCR) strongly positive for herpes simplex virus ( HSV) type 1, CMV and Epstein-Barr virus ( CMV) synchronous infection. Later it was performed a colonoscopy that revealed the presence of a malignant neoplasm in sigmoid colon, confirmed after histological evaluation. The patient was then referred for symptomatic treatment.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 2