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(+).