Abstract
Immunodeficient patients can develop malabsorption, mimicking celiac disease clinically and histologically. Such individuals may also occasionally require immunosuppressive therapy for autoimmune disorders. We have identified a patient with common variable immunodeficiency (CVID)-associated sprue complicated by duodenal cytomegalovirus (CMV) infection following corticosteroid and ancillary immunomodulatory therapy. Ganciclovir and a modification of the immunosuppressant regimen improved both clinical symptoms and villous atrophy. To our knowledge, this is original documentation of duodenal CMV infection secondary to immunomodulatory therapy for steroid-refractory CVID-sprue.
Int J Surg Pathol 14(1):101-106, 2006.
MeSH terms
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Adrenal Cortex Hormones / therapeutic use
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Antibodies, Monoclonal / therapeutic use
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Antiviral Agents / therapeutic use
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Azathioprine / therapeutic use
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Celiac Disease / complications*
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Celiac Disease / diagnosis
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Celiac Disease / drug therapy*
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Common Variable Immunodeficiency / complications*
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Common Variable Immunodeficiency / diagnosis
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Common Variable Immunodeficiency / drug therapy*
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Cytomegalovirus / isolation & purification
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Cytomegalovirus Infections / complications*
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Cytomegalovirus Infections / diagnosis
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Cytomegalovirus Infections / drug therapy
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Diagnosis, Differential
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Drug Resistance
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Duodenum / drug effects
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Duodenum / pathology
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Duodenum / virology
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Female
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Ganciclovir / therapeutic use
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Humans
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Immunologic Factors / therapeutic use
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Immunosuppressive Agents / therapeutic use*
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Infliximab
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Lymphoma, T-Cell / diagnosis
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Lymphoma, T-Cell / etiology
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Lymphoma, T-Cell / pathology
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Middle Aged
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Prednisone / therapeutic use
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Steroids / therapeutic use*
Substances
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Adrenal Cortex Hormones
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Antibodies, Monoclonal
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Antiviral Agents
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Immunologic Factors
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Immunosuppressive Agents
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Steroids
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Infliximab
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Azathioprine
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Ganciclovir
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Prednisone