Seronegative invasive gastro‑intestinal cytomegalovirus disease in renal allograft recipients a diagnostic dilemma! – Tissue PCR the saviour.
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Date
2015-07
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Abstract
Seronegative Invasive Gastro-intestinal cytomegalovirus disease in renal allograft recipients Background –CMV as
oppurtunistic infection affecting the gastrointerstinal tract is the most common cause for tissue invasive CMV disease occuring
in 10–30% of organ transplant recepients. Gastrointerstinal CMV disease can be diagnosed in presence of clinical suspecion
along with histopathological findings (CMV inclusions) and presence of mucosal lesion(s) on endoscopic examination with
collaborative evidences via molecular technique. Aims-Few cases of CMV infection affecting the gastrointerstinal tract show
no evidences of dissemintion despite use of highly sensitive molecular techniques. We encountered 6 cases where in despite
strong clinical suspecion of Gastrointerstinal CMV disease there were seronegative and endoscopic negative evidences for
CMV, blind tissue biopsy yeilded positive results for CMV disease with excellent improvement with antiviral therapy.
Conclusions-Blind biopsy specimen for tissue PCR could serve as saviour in an immunocompromised individiual who has a
strong clinical symptomatology for GI-CMV disease in absence of viremia, normal endoscopy and histopathology, so that the
early therapeutic interventions could help in excellent patient and graft survival.
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Keywords
Cytomegalovirus disease invasive, gastrointerstinal, gastrointerstinal disaese, renal transplant
Citation
Kaul A, Bhadauria D, Agarwal V, Ruhela V, Kumar A, Mohendra S, Barai S, Prasad N, Gupta A, Sharma R K. Seronegative invasive gastro‑intestinal cytomegalovirus disease in renal allograft recipients a diagnostic dilemma! – Tissue PCR the saviour. Indian Journal of Medical Microbiology. 2015 Jul-Sept; 33 (3): 447-452.