Refractory Cytomegalovirus Colitis Followed by De Novo Inflammatory Bowel Disease Post-Orthotopic Liver Transplantation

Bharathi Selvan; Avani A Pendse; Cecelia Zhang; Jeffriann Cauthen; Matthew R Kappus; Julia A Messina

doi:10.14309/crj.0000000000001232

Refractory Cytomegalovirus Colitis Followed by De Novo Inflammatory Bowel Disease Post-Orthotopic Liver Transplantation

ACG Case Rep J. 2023 Dec 16;10(12):e01232. doi: 10.14309/crj.0000000000001232. eCollection 2023 Dec.

Authors

Bharathi Selvan¹, Avani A Pendse², Cecelia Zhang³, Jeffriann Cauthen³, Matthew R Kappus³, Julia A Messina⁴

Affiliations

¹ Duke University School of Medicine, Durham, NC.
² Department of Pathology, Duke University School of Medicine, Durham, NC.
³ Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, Durham, NC.
⁴ Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC.

Abstract

Cytomegalovirus (CMV) and inflammatory bowel disease (IBD) are both immune-mediated complications that affect orthotopic liver transplantation patients. In this report, we present a 60-year-old man who underwent orthotopic liver transplantation for cryptogenic cirrhosis with serologies notable for CMV-seropositive donor and seronegative recipient. His post-transplant course was initially complicated by probable refractory CMV colitis. However, his gastrointestinal symptoms persisted, eventually leading to a diagnosis of post-transplant de novo IBD. The discussion highlights theories regarding the association between CMV and IBD, a topic that has been widely debated for decades.

Keywords: cytomegalovirus; inflammatory bowel disease; liver transplantation.

Publication types

Case Reports