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Value of laboratory investigations in clinical suspicion of cytomegalovirus-induced upper gastrointestinal tract ulcerations in HIV-infected patients

1996; Wiley; Volume: 49; Issue: 1 Linguagem: Inglês

10.1002/(sici)1096-9071(199605)49

1096-9071

J W Dorigo-Zetsma, Jan T. M. van der Meer, M Tersmette, F. J. W. Ten Kate, P. M. E. Wertheim‐van Dillen, J. van der Noordaa,

Immunodeficiency and Autoimmune Disorders

Journal of Medical VirologyVolume 49, Issue 1 p. 29-33 Value of laboratory investigations in clinical suspicion of cytomegalovirus-induced upper gastrointestinal tract ulcerations in HIV-infected patients J.W. Dorigo-Zetsma, Corresponding Author J.W. Dorigo-Zetsma Laboratory of Medical Microbiology, Department of Clinical Virology, Academic Medical Center, Amsterdam, The NetherlandsLaboratory of Medical Microbiology, Department of Clinical Virology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands===Search for more papers by this authorJ.T.M. van der Meer, J.T.M. van der Meer Department of Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, Amsterdam, The NetherlandsSearch for more papers by this authorM. Tersmette, M. Tersmette Laboratory of Medical Microbiology, Department of Clinical Virology, Academic Medical Center, Amsterdam, The NetherlandsSearch for more papers by this authorF.J.W. ten Kate, F.J.W. ten Kate Laboratory of Pathology, Academic Medical Center, Amsterdam, The NetherlandsSearch for more papers by this authorP.M.E. Wertheim-van Dillen, P.M.E. Wertheim-van Dillen Laboratory of Medical Microbiology, Department of Clinical Virology, Academic Medical Center, Amsterdam, The NetherlandsSearch for more papers by this authorJ. van der Noordaa, J. van der Noordaa Laboratory of Medical Microbiology, Department of Clinical Virology, Academic Medical Center, Amsterdam, The NetherlandsSearch for more papers by this author J.W. Dorigo-Zetsma, Corresponding Author J.W. Dorigo-Zetsma Laboratory of Medical Microbiology, Department of Clinical Virology, Academic Medical Center, Amsterdam, The NetherlandsLaboratory of Medical Microbiology, Department of Clinical Virology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands===Search for more papers by this authorJ.T.M. van der Meer, J.T.M. van der Meer Department of Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, Amsterdam, The NetherlandsSearch for more papers by this authorM. Tersmette, M. Tersmette Laboratory of Medical Microbiology, Department of Clinical Virology, Academic Medical Center, Amsterdam, The NetherlandsSearch for more papers by this authorF.J.W. ten Kate, F.J.W. ten Kate Laboratory of Pathology, Academic Medical Center, Amsterdam, The NetherlandsSearch for more papers by this authorP.M.E. Wertheim-van Dillen, P.M.E. Wertheim-van Dillen Laboratory of Medical Microbiology, Department of Clinical Virology, Academic Medical Center, Amsterdam, The NetherlandsSearch for more papers by this authorJ. van der Noordaa, J. van der Noordaa Laboratory of Medical Microbiology, Department of Clinical Virology, Academic Medical Center, Amsterdam, The NetherlandsSearch for more papers by this author First published: May 1996 https://doi.org/10.1002/(SICI)1096-9071(199605)49:1 3.0.CO;2-MCitations: 2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract To assess the value of laboratory investigations for the diagnosis and treatment of cytomegalovirus-induced upper gastrointestinal tract ulcerations, the medical records and biopsy material from HIV-infected patients were reviewed retrospectively during a 12-month period. Clinical diagnosis of cytomegalovirus (CMV) ulceration, based on characteristic endoscopic appearance of extensive ulceration of the mid- to distal esophageal or gastric mucosa and responsiveness to anti-CMV therapy, was compared with laboratory investigations of biopsies. Laboratory procedures consisted of both histopathological examination of the biopsy specimens and viral culture. Twenty episodes in 12 HIV-infected patients could be evaluated. Clinical diagnosis of CMV ulceration appeared to be justified in 14 of 20 episodes (70%), which were confirmed by laboratory investigations. Of the remaining six episodes, which showed partial or no response to anti-CMV therapy, laboratory investigations were negative in two episodes and discrepant in four episodes (histopathology or viral culture positive). A good response to anti-CMV therapy was more frequent in patients whose biopsies proved positive by histopathological examination and/or viral culture than in patients with negative tests (82% versus 0%), which indicates the importance of both investigations. In conclusion, laboratory diagnosis of CMV-induced upper gastrointestinal tract ulcerations supported the diagnosis and decisions on treatment of CMV-induced upper gastrointestinal tract ulcerations. © 1996 Wiley-Liss, Inc. References Bach MC, Howell DA, Valenti AJ, Smith TJ, Winslow DL (1990): Aphthous ulceration of the gastrointestinal tract in patients with the acquired immunodeficiency syndrome. Annals of Internal Medicine 112: 465– 466. 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