Pai-Jui Yeh1, Cheng-Tang Chiu2, Ming-Wei Lai3, Ren-Chin Wu4, Chia-Jung Kuo2, Jun-Te Hsu5, Ming-Yao Su6, Puo-Hsien Le7. 1. Department of Pediatric Gastroenterology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan. 2. Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, Taoyuan, Taiwan; Taiwan Association of the Study of Small Intestinal Disease, Taiwan. 3. Department of Pediatric Gastroenterology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; Taiwan Association of the Study of Small Intestinal Disease, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taiwan. 4. Department of Pathology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan. 5. Department of General Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan. 6. Taiwan Association of the Study of Small Intestinal Disease, Taiwan; Department of Gastroenterology and Hepatology, New Taipei City Municipal Tucheng Hospital (Chang Gung Memorial Hospital), Tucheng branch, Taiwan. 7. Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch5, Fu-Hsin Street, Guei-Shan District, Taoyuan City, Taoyuan, Taiwan; Taiwan Association of the Study of Small Intestinal Disease, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taiwan. Electronic address: b9005031@cgmh.org.tw.
Abstract
BACKGROUND: Cytomegalovirus (CMV) gastritis is occasionally reported in case reports and limited case series. Up to now, it is the largest and most comprehensive retrospective study of CMV gastritis. METHODS: All patients who were histologically diagnosed with CMV gastritis at Linkou Chang Gung Memorial Hospital between January 2000 and April 2020 were included. Patients were divided into two groups according to immunity. Between-group differences in characteristics, manifestations, endoscopic features, prognostic factors, and outcomes were analyzed. The main endpoint was 3-month mortality. RESULTS: A total of 54 patients (34 immunocompromised, 20 immunocompetent) were enrolled. Common presentations included gastrointestinal bleeding (35.2%), abdominal pain (33.3%) and fever (31.5%). The endoscopic features included ulcer (88.9%) and inflammation (11.1%). The 3-month mortality rate was 20.4% and overall mortality rate was 40.7%. Acute kidney injury was the only independent risk factor for 3-month mortality (OR 53.89, 95%CI 1.56-1861.73, p = 0.027). Anti-viral therapy and host immune status did not affect 3-month mortality. CONCLUSION: Both immunocompromised and immunocompetent patients with CMV gastritis have high mortality rates, without significant between-group differences. Acute kidney injury is the only independent predictive factor for 3-month mortality. Prevention of acute kidney injury may possibly improve the 3-month mortality rate.
BACKGROUND: Cytomegalovirus (CMV) gastritis is occasionally reported in case reports and limited case series. Up to now, it is the largest and most comprehensive retrospective study of CMV gastritis. METHODS: All patients who were histologically diagnosed with CMV gastritis at Linkou Chang Gung Memorial Hospital between January 2000 and April 2020 were included. Patients were divided into two groups according to immunity. Between-group differences in characteristics, manifestations, endoscopic features, prognostic factors, and outcomes were analyzed. The main endpoint was 3-month mortality. RESULTS: A total of 54 patients (34 immunocompromised, 20 immunocompetent) were enrolled. Common presentations included gastrointestinal bleeding (35.2%), abdominal pain (33.3%) and fever (31.5%). The endoscopic features included ulcer (88.9%) and inflammation (11.1%). The 3-month mortality rate was 20.4% and overall mortality rate was 40.7%. Acute kidney injury was the only independent risk factor for 3-month mortality (OR 53.89, 95%CI 1.56-1861.73, p = 0.027). Anti-viral therapy and host immune status did not affect 3-month mortality. CONCLUSION: Both immunocompromised and immunocompetent patients with CMV gastritis have high mortality rates, without significant between-group differences. Acute kidney injury is the only independent predictive factor for 3-month mortality. Prevention of acute kidney injury may possibly improve the 3-month mortality rate.