inovmedИнновационная медицина КубаниInnovative Medicine of Kuban2541-9897Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 110.35401/2541-9897-2024-9-2-87-92inovmed-849Research ArticleСЛУЧАИ ИЗ КЛИНИЧЕСКОЙ ПРАКТИКИCASE REPORTSЦитомегаловирусный колит (клинический случай)Cytomegalovirus Colitis: A Case Reporthttps://orcid.org/0000-0002-3405-7668ТищенкоГ. В.TishchenkoG. V.

Тищенко Григорий Витальевич, к. м. н., доцент кафедры патологической анатомии

246050, Гомель, ул. Ланге, 5

Grigorii V. Tishchenko, Cand. Sci. (Med), Associate Professor at the Department of Anatomical Pathology

ulitsa Lange 5, Gomel, 246050

mail@gtishchenko.ruhttps://orcid.org/0000-0002-8905-4296ГлавацкаяИ. П.HlavatskayaI. P.

Главацкая Ирина Петровна, ассистент кафедры патологической анатомии

Гомель

Iryna P. Hlavatskaya, Assistant Professor at the Departmentof Anatomical Pathology

Gome

Гомельский государственный медицинский университетБеларусьGomel State Medical UniversityBelarus202430062024028792Copyright © Тищенко Г.В., Главацкая И.П., 20242024Тищенко Г.В., Главацкая И.П.Tishchenko G.V., Hlavatskaya I.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.innovmedkub.ru/jour/article/view/849

В данной статье представлен клинический случай цитомегаловирусного колита. У пациентки – молодой женщины с предварительным диагнозом «болезнь Крона» – наблюдались сильная боль в животе, диарея и потеря веса. Несмотря на трудности дифференциальной диагностики, удалось поставить правильный диагноз по результатам гистологического исследования биоптата, полученного при колоноскопии: наличие внутриядерных включений, характерных для цитомегаловируса, и специфические изменения слизистой оболочки кишки, связанные с цитомегаловирусом. Данный клинический случай подчеркивает важность патогистологического исследования в дифференциальной диагностике воспалительных заболеваний желудочно-кишечного тракта.

We report a case of cytomegalovirus (CMV) colitis. The patient (a woman with a provisional diagnosis of Crohn disease) presented with severe abdominal pain, diarrhea, and weight loss. Despite difficulties in differential diagnosis, we were able to make the correct diagnosis based on findings of the histological examination of the biopsy specimens obtained during colonoscopy: intranuclear inclusions characteristic of CMV and specific CMV-associated changes in the intestinal mucosa. This case highlights the importance of histopathological examination in differential diagnosis of inflammatory diseases of the gastrointestinal tract.

цитомегаловирусцитомегаловирусный колитиммуносупрессияпатологияcytomegaloviruscytomegalovirus colitisimmunosuppressionpathologyReferencesБалмасова И.П., Сепиашвили Р.И. Цитомегаловирус и естественные киллеры: новые подходы к проблеме. Аллергология и иммунология. 2016;17(1):12–17.Balmasova IP, Sepiashvili RI. Cytomegaloviruses and natural killer cells: new approaches to the problem. Allergologiya i immunologiya. 2016;17(1):12–17. (In Russ.).Ситкин С.И., Авалуева Е.Б., Бакулин И.Г. и др. Роль бактериальных, грибковых и вирусных инфекций в патогенезе воспалительных заболеваний кишечника. Инфекционные болезни. 2023;21(2):64–81. https://doi.org/10.20953/1729-9225-2023-2-64-81Sitkin SI, Avalueva EB, Bakulin IG, et al. The role of bacterial, fungal, and viral infections in the pathogenesis of inflammatory bowel diseases. Infekcionnye bolezni. 2023;21(2):64–81. (In Russ.). https://doi.org/10.20953/1729-9225-2023-2-64-81Александров Т.Л., Нанаева Б.А., Баранова Т.А. и др. Влияние цитомегаловирусной инфекции на течение язвенного колита средней и тяжелой степени. Колопроктология. 2021;20(3):28–34. https://doi.org/10.33878/2073-7556-2021-20-3-28-34Alexandrov TL, Nanaeva BA, Baranova TA, et al. Effect of cytomegalovirus infection on moderate and severe ulcerative colitis. Koloproktologia. 2021;20(3):28–34. (In Russ.). https://doi.org/10.33878/2073-7556-2021-20-3-28-34 4. El Baba R, Herbein G. Immune landscape of CMV infection in cancer patients: from “canonical” diseases toward viruselicited oncomodulation. Front Immunol. 2021;12:730765. PMID: 34566995. PMCID: PMC8456041. https://doi.org/10.3389/fimmu.2021.730765El Baba R, Herbein G. Immune landscape of CMV infection in cancer patients: from “canonical” diseases toward viruselicited oncomodulation. Front Immunol. 2021;12:730765. PMID: 34566995. PMCID: PMC8456041. https://doi.org/10.3389/fimmu.2021.730765Reddehase MJ. Margaret Gladys Smith, mother of cytomegalovirus: 60th anniversary of cytomegalovirus isolation. Med Microbiol Immunol. 2015;204(3):239–241. PMID: 25864083. https://doi.org/10.1007/s00430-015-0416-zReddehase MJ. Margaret Gladys Smith, mother of cytomegalovirus: 60th anniversary of cytomegalovirus isolation. Med Microbiol Immunol. 2015;204(3):239–241. PMID: 25864083. https://doi.org/10.1007/s00430-015-0416-zKaushik AC, Mehmood A, Upadhyay AK, et al. CytoMegaloVirus infection database: a public omics database for systematic and comparable information of CMV. Interdiscip Sci. 2020;12(2):169–177. PMID: 31813095. https://doi.org/10.1007/s12539-019-00350-xKaushik AC, Mehmood A, Upadhyay AK, et al. CytoMegaloVirus infection database: a public omics database for systematic and comparable information of CMV. Interdiscip Sci. 2020;12(2):169–177. PMID: 31813095. https://doi.org/10.1007/s12539-019-00350-xGriffiths P, Reeves M. Pathogenesis of human cytomegalovirus in the immunocompromised host. Nat Rev Microbiol. 2021;19(12):759–773. PMID: 34168328. PMCID: PMC8223196. https://doi.org/10.1038/s41579-021-00582-zGriffiths P, Reeves M. Pathogenesis of human cytomegalovirus in the immunocompromised host. Nat Rev Microbiol. 2021;19(12):759–773. PMID: 34168328. PMCID: PMC8223196. https://doi.org/10.1038/s41579-021-00582-zKochkina SS, Sitnikova EP. Cytomegalovirus infection in children. Children Infections. 2016;15(1):39–44. (In Russ.).Кочкина С.С., Ситникова Е.П. Цитомегаловирусная инфекция у детей. Детские инфекции. 2016;15(1):39–44.Kochkina SS, Sitnikova EP. Specific Features of cytomegalovirus infection: literature review. Doctor.Ru. 2016;(6):62–67. (In Russ.).Кочкина С.С., Ситникова Е.П. Особенности цитомегаловирусной инфекции: обзор литературы. Доктор.ру. 2016; (6):62–67.Kuzmichev DE, Skrebov RV, Viltsev IM. Morphological features of cytomegalovirus infection. Zdravookhranenie Yugry: opyt i innovatsii. 2020;(1):57–59. (In Russ.).Кузьмичев Д.Е., Скребов Р.В., Вильцев И.М. Морфологические особенности цитомегаловирусной инфекции. Здравоохранение Югры: опыт и инновации. 2020;(1):57–59.Jenks CM, Hoff SR, Mithal LB. Congenital cytomegalovirus infection: epidemiology, timely diagnosis, and management. Neoreviews. 2021;22(9):e606–e613. PMID: 34470762. https://doi.org/10.1542/neo.22-9-e606Jenks CM, Hoff SR, Mithal LB. Congenital cytomegalovirus infection: epidemiology, timely diagnosis, and management. Neoreviews. 2021;22(9):e606–e613. PMID: 34470762. https://doi.org/10.1542/neo.22-9-e606Goetgebuer RL, van der Woude CJ, Bakker L, van der Eijk AA, de Ridder L, de Vries AC. The diagnosis and management of CMV colitis in IBD patients shows high practice variation: a national survey among gastroenterologists. Scand J Gastroenterol. 2022;57(11):1321–1326. PMID: 35771203. https://doi.org/10.1080/00365521.2022.2088244Goetgebuer RL, van der Woude CJ, Bakker L, van der Eijk AA, de Ridder L, de Vries AC. The diagnosis and management of CMV colitis in IBD patients shows high practice variation: a national survey among gastroenterologists. Scand J Gastroenterol. 2022;57(11):1321–1326. PMID: 35771203. https://doi.org/10.1080/00365521.2022.2088244Fisher AT, Bessoff KE, Nicholas V, Badger J, Knowlton L, Forrester JD. Fatal case of perforated cytomegalovirus colitis: case report and systematic review. Surg Infect (Larchmt). 2022;23(2):127–134. PMID: 34860604. https://doi.org/10.1089/sur.2021.173Fisher AT, Bessoff KE, Nicholas V, Badger J, Knowlton L, Forrester JD. Fatal case of perforated cytomegalovirus colitis: case report and systematic review. Surg Infect (Larchmt). 2022;23(2):127–134. PMID: 34860604. https://doi.org/10.1089/sur.2021.173Yerushalmy-Feler A, Padlipsky J, Cohen S. Diagnosis and management of CMV colitis. Curr Infect Dis Rep. 2019;21(2):5. PMID: 30771028. https://doi.org/10.1007/s11908-019-0664-yYerushalmy-Feler A, Padlipsky J, Cohen S. Diagnosis and management of CMV colitis. Curr Infect Dis Rep. 2019;21(2):5. PMID: 30771028. https://doi.org/10.1007/s11908-019-0664-yKo JH, Peck KR, Lee WJ, et al. Clinical presentation and risk factors for cytomegalovirus colitis in immunocompetent adult patients. Clin Infect Dis. 2015;60(6):e20–e26. PMID: 25452594. https://doi.org/10.1093/cid/ciu969Ko JH, Peck KR, Lee WJ, et al. Clinical presentation and risk factors for cytomegalovirus colitis in immunocompetent adult patients. Clin Infect Dis. 2015;60(6):e20–e26. PMID: 25452594. https://doi.org/10.1093/cid/ciu969Salehi M, Shafiee N, Moradi M. Cytomegalovirus colitis in immunocompetent hosts: a case report and literature review. Clin Case Rep. 2024;12(1):e8435. PMID: 38197061. PMCID: PMC10774537. https://doi.org/10.1002/ccr3.8435Salehi M, Shafiee N, Moradi M. Cytomegalovirus colitis in immunocompetent hosts: a case report and literature review. Clin Case Rep. 2024;12(1):e8435. PMID: 38197061. PMCID: PMC10774537. https://doi.org/10.1002/ccr3.8435Wu XW, Wu L, Ji HZ, Wang FY. Relationship between cytomegalovirus infection and steroid resistance in inflammatory bowel disease: a meta-analysis. Dig Dis Sci. 2015;60(11):3203– 3208. PMID: 26031424. PMCID: PMC4621704. https://doi. org/10.1007/s10620-015-3733-6Wu XW, Wu L, Ji HZ, Wang FY. Relationship between cytomegalovirus infection and steroid resistance in inflammatory bowel disease: a meta-analysis. Dig Dis Sci. 2015;60(11):3203– 3208. PMID: 26031424. PMCID: PMC4621704. https://doi.org/10.1007/s10620-015-3733-6Xiang J, Li J, Liu C, Tian S, Dong W. Clinical features of Crohn’s disease stratified by age at diagnosis according to Montreal classification. J Inflamm Res. 2023;16:737–746. PMID: 36852301. PMCID: PMC9960709. https://doi.org/10.2147/jir.s397483Xiang J, Li J, Liu C, Tian S, Dong W. Clinical features of Crohn’s disease stratified by age at diagnosis according to Montreal classification. J Inflamm Res. 2023;16:737–746. PMID: 36852301. PMCID: PMC9960709. https://doi.org/10.2147/jir.s397483Xiang J, Li J, Liu C, Tian S, Dong W. Clinical features of Crohn’s disease stratified by age at diagnosis according to Montreal classification. J Inflamm Res. 2023;16:737–746. PMID: 36852301. PMCID: PMC9960709. https://doi.org/10.2147/jir.s397483

The authors declare that there are no conflicts of interest present.