Investigations and Treatment
The serum level of CMV DNA was positive(8.33E+02 copies/mL) in our
hospital, and the autoimmunity screening, including antinuclear
antibodies, rheumatoid factors, anti-ENA autoantibody profiles, and
antineutrophilic cytoplasmic antibodies was negative. According to the
medical history, symptoms, laboratory and endoscopic examination
results, GS combined with CMV gastroenteritis was definitely diagnosed.
Subsequently, she received antiviral therapy with foscarnet sodium
injection(3g q8h ivgtt), intermittent
administration of human immunoglobulin(5g/d), and continuous supplement
of potassium, calcium, and magnesium. Afterwards, the patient felt
better than before. Gastroscopy reexamination showed hyperemia and edema
of gastric body mucosa, erythema of antrum mucosa, and a 0.8cm mucous
protrusive lesion near the pylorus in the anterior wall, with rough and
red surface, and soft biopsy quality. Biopsy suggested mild chronic
inflammation of mucosa with suspicious inclusion body deposition, and
further immunohistochemistry indicated that CMV was negative.
Colonoscopy revealed a 0.3cm polyp in the transverse colon near hepatic
curvature with soft biopsy. Scattered mucosal patches of sigmoid colon
were congested. The rectal mucosa was scattered in sheets with hyperemia
and erosion(Figure 1). Pathological biopsy results showed severe chronic
inflammation of mucosa with activity (+ ++), crypt abscess with erosion,
decreased glands, CMV (+), CD68PGM-1(+).