Year 2023 / Volume 115 / Number 2
Letter
Acute gastrointestinal graft-versus-host disease with cytomegalovirus and Epstein-Barr virus superinfection in a patient with COVID-19

92-93

DOI: 10.17235/reed.2022.9001/2022

Emanuel Dias, Margarida Marques, Susana Lopes, Irene Gullo, Juliana Bastos, Guilherme Macedo,

Abstract
A 60-year-old female was diagnosed with acute myeloid leukemia. After initial remission with chemotherapy, she relapsed and underwent allogeneic hematopoietic stem cell transplantation (HSCT). Two months later, she presented to emergency department with watery diarrhea, abdominal pain and fever. She also tested positive for SARS-CoV2 on nasopharyngeal swab by polymerase chain reaction (PCR) and both cytomegalovirus (CMV) and Epstein-Barr virus (EBV) were detected in peripheral blood. Flexible sigmoidoscopy showed diffuse edema, erythema and loss of vascular pattern with interspersed segments of mucosal denudation and exudate and bBiopsies revealed epithelial cell apoptosis, diffuse crypt atrophy and dropout, with ulceration and both CMV and EBV were detected in colon mucosa, consistent with acute severe gastrointestinal graft-versus-host disease complicated by CMV and EBV superinfection. Despite starting therapy with methylprednisolone, ganciclovir and rituximab,she presented unfavorable evolution and died after 5 weeks.
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References
1. Naymagon S, Naymagon L, Wong SY, et al. Acute graft-versus-host disease of the gut: considerations for the gastroenterologist. Nat Rev Gastroenterol Hepatol. 2017;14(12):711-26.
2. Velasco-Guardado A, López-Corral L, Alvarez-Delgado A, et al. Endoscopic evaluation and histological findings in graft-versus-host disease. Rev Esp Enferm Dig. 2012;104(6):310-4.
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Citation tools
Dias E, Marques M, Lopes S, Gullo I, Bastos J, Macedo G, et all. Acute gastrointestinal graft-versus-host disease with cytomegalovirus and Epstein-Barr virus superinfection in a patient with COVID-19. 9001/2022


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Publication history

Received: 10/06/2022

Accepted: 14/06/2022

Online First: 24/06/2022

Published: 07/02/2023

Article Online First time: 14 days

Article editing time: 242 days


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