Acute gastrointestinal graft-versus-host disease with cytomegalovirus and Epstein-Barr virus superinfection in a patient with COVID-19

• Type: Another Publication in an International Scientific Journal
• Date: 2023

Authors

Dias, E (Author) Other; Marques, M (Author) Other; Lopes, S (Author) Other; Gullo, I (Author) Other; Bastos, J (Author) FMUP; Macedo G (Author) FMUP

Journal

Title: Revista Espanola de Enfermedades Digestivas

Vol. 115

Pages: 92-93

ISSN: 1130-0108

Publisher: Aran Ediciones SA

Indexing

ISI Web of Knowledge - 2 Citations

Scopus - 1 Citation

Other information

Authenticus ID: P-00X-YGK

DOI: 10.17235/reed.2022.9001/2022

Abstract (EN): A 60-year-old female was diagnosed with acute myeloid leukemia. After initial remission with chemotherapy, she relapsed and underwent allogeneic hematopoietic stem cell transplantation (HSCT). Two months later, she presented to the emergency department with watery diarrhea, abdominal pain and fever. Laboratory studies revealed elevated C-reactive protein (206.7 mg/L) and acute kidney injury (creatinine 2.43 mg/dL). She also tested positive for SARS-CoV-2 on nasopharyngeal swab by polymerase chain reaction (PCR) and both cytomegalovirus (CMV) and Epstein-Barr virus (EBV) were detected in peripheral blood. She was admitted to the intensive care unit under renal replacement therapy with resolution of an acute kidney injury. In contrast, the diarrhea did not improve and she developed rectal bleeding, which prompted a flexible sigmoidoscopy that showed diffuse edema, erythema and loss of vascular pattern (Fig. 1A) with interspersed segments of mucosal denudation and exudate (Fig. 1B). Biopsies revealed epithelial cell apoptosis, diffuse crypt atrophy and dropout, with ulceration (Figs. 1 C and D) and both CMV and EBV were detected in the colon mucosa. These features were consistent with acute severe ed by CMV and EBV superinfection. Despite starting therapy with methylprednisolone, ganciclovir and rituximab, gastrointestinal symptoms did not improve and her general condition gradually worsened. She also developed acute liver failure and died 5 weeks later.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 2