de Andrade LGM, Rodrigues MAM, Romeiro FG, Carvalho MFC. Gastrointestinal cytomegalovirus disease in renal transplant recipients: a case series.
Clin Transplant 2011 DOI: 10.1111/j.1399-0012.2011.01514.x.
© 2011 John Wiley & Sons A/S.
Abstract: The purpose of this article was to report a series of 23 renal transplant recipients with histologically proven and immunohistochemically confirmed cytomegalovirus (CMV) lesions in the gastrointestinal tract (GIT) and to assess the risk factors associated with severe disease/mortality. CMV patients (n = 23) were allocated into two groups: those who died (n = 6) and those considered cured (n = 17). Overall mortality rate was 26% (6/23). Initial symptoms suggestive of lower GIT involvement were observed in all death cases and in 35.3% of those cured (p = 0.01). Enterorrhagia was seen in 83.3% of the patients who died. Death risk increased twofold (RR 2 [1.13–3.52], p = 0.01) when symptoms of lower GIT involvement were initially observed and sixfold when enterrohagia was present (RR 6 [1.1–35.9], p = 0.001). Among death cases, mean time at diagnosis was significantly more distant (2002 ± 2.9 × 2008 ± 1.6, p = 0.04). The difference in mortality rates seen as service practices changed along the years demonstrates the importance of early diagnosis.