Cytomegalovirus cholangitis and pancreatitis in an immunocompetent patient

Oku, Takatomi; Maeda, Masahiro; Waga, Eriko; Wada, Yuko; Nagamachi, Yukio; Fujita, Miri; Suzuki, Yasuhiro; Nagashima, K.; Niitsu, Yoshiro

doi:10.1007/s00535-005-1683-z

Cited by 35 publications

(12 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Liver T‐cell responses to CMV were identified in a majority of BA patients at diagnosis, suggesting perinatal CMV infection as a plausible initiator of bile duct damage. CMV, a double‐stranded DNA virus from the Herpesviridae family, is known to infect and injure bile duct epithelia, as demonstrated by CMV inclusion bodies or positive CMV antigens within bile duct epithelia 46‐49. Evidence for CMV infection at the time of diagnosis of BA has been described in the past 15, 22‐30.…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus-specific T-cell reactivity in biliary atresia at the time of diagnosis is associated with deficits in regulatory T cells

et al. 2012

View full text Add to dashboard Cite

Biliary atresia (BA) is a progressive, inflammatory cholangiopathy that culminates in fibrosis of extrahepatic and intrahepatic bile ducts. A leading theory on the pathogenesis of BA is that the bile duct damage is initiated by a virus infection, followed by a bile duct-targeted autoimmune response. One mechanism of autoimmunity entails diminished number or function of regulatory T cells (Tregs). The aim of this study was to identify potential virus-specific liver T cells from infants with BA at the time of diagnosis, implicating the virus involved in early bile duct damage. A subaim was to determine if presence of virus infection was associated with quantitative changes in Tregs. Results: Liver T cells from BA and control patients were cultured with antigen presenting cells in the presence of a variety of viral or control proteins. 56% of BA patients had significant increases in IFN-γ-producing liver T cells in response to cytomegalovirus (CMV), compared to minimal BA responses to other viruses or the control group CMV response. In addition, a positive correlation between BA plasma CMV IgM and liver T cell CMV reactivity was identified. Investigation of peripheral blood Tregs revealed significant deficits in Tregs frequencies in BA compared to controls, with marked deficits in those BA patients who were positive for CMV. Conclusions: Liver T cell responses to CMV were identified in the majority of BA patients at diagnosis, suggesting perinatal CMV infection as a plausible initiator of bile duct damage. Deficiency of Tregs in BA implies decreased inhibition of inflammation and autoreactivity, potentially allowing for exaggerated bile duct injury.

show abstract

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus-specific T-cell reactivity in biliary atresia at the time of diagnosis is associated with deficits in regulatory T cells

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Most diagnoses in case reports are based on acute pancreatitis in the setting of CMV viremia with demonstrated response to CMV treatment [36–38]. Cholangitis with CMV involvement of the biliary epithelium has also been reported [39]. Therefore, although rare, these clinical entities merit consideration, especially in immunocompromised patients.…”

Section: CMV In the General Population: Presentation Diagnosis Amentioning

confidence: 99%

A Practical Review of Cytomegalovirus in Gastroenterology and Hepatology

Fakhreddine

Frenette

Konijeti

2019

Gastroenterology Research and Practice

View full text Add to dashboard Cite

Human cytomegalovirus (CMV) is a ubiquitous Herpesviridae virus with a wide spectrum of pathology in humans. Host immunity is a major determinant of the clinical manifestation of CMV and can vary widely in the gastroenterology and hepatology practice setting. Immunocompetent patients generally develop a benign, self-limited mononucleosis-like syndrome whereas gastrointestinal tissue-invasive disease is more frequently seen in immunocompromised and inflammatory bowel disease patients. Additionally, liver allograft dysfunction is a significant consequence of CMV infection in liver transplant patients. While polymerase chain reaction and immunohistochemistry techniques allow for the reliable and accurate detection of CMV in the human host, the diagnostic value of different serologic, endoscopic, and histologic tests depends on a variety of factors. Similarly, latent CMV, CMV infection, and CMV disease carry different significance depending on the patient population, and the decision to initiate antiviral therapy can be complex and patient-specific. This review will focus on the pathophysiology, diagnosis, and management of CMV in patient populations relevant to the practice of gastroenterology and hepatology—liver transplant recipients, inflammatory bowel disease patients, and otherwise immunocompetent patients.

show abstract

“…In a few studies, paromomycin, azithromycin, and more recently nitazoxanide have been used without promising results[ 46 , 47 ]. Intravenous gancyclovir and foscarnet are also not beneficial for treatment of CMV-related cholangitis[ 48 ]. Though albendazole has been used with some success in disseminated Enterocytozoon intestinalis infection including cholangitis, the therapeutic effect seems to be transient[ 49 ].…”

Section: Diagnosismentioning

confidence: 99%

Epidemiology, determinants, and management of AIDS cholangiopathy: A review

Naseer¹,

Dailey²,

Juboori³

et al. 2018

WJG

View full text Add to dashboard Cite

Diseases of the liver and biliary tree have been described with significant frequency among patients with human immunodeficiency virus (HIV), and its advanced state, acquired immunodeficiency syndrome (AIDS). Through a variety of mechanisms, HIV/AIDS has been shown to affect the hepatic parenchyma and biliary tree, leading to liver inflammation and biliary strictures. One of the potential hepatobiliary complications of this viral infection is AIDS cholangiopathy, a syndrome of biliary obstruction and liver damage due to infection-related strictures of the biliary tract. AIDS cholangiopathy is highly associated with opportunistic infections and advanced immunosuppression in AIDS patients, and due to the increased availability of highly active antiretroviral therapy, is now primarily seen in instances of poor access to anti-retroviral therapy and medication non-compliance. While current published literature describes well the clinical, biochemical, and endoscopic management of AIDS-related cholangiopathy, information on its epidemiology, natural history, and pathology are not as well defined. The objective of this review is to summarize the available literature on AIDS cholangiopathy, emphasizing its epidemiology, course of disease, and determinants, while also revealing an updated approach for its evaluation and management.

show abstract

Cytomegalovirus cholangitis and pancreatitis in an immunocompetent patient

Cited by 35 publications

References 21 publications

Cytomegalovirus-specific T-cell reactivity in biliary atresia at the time of diagnosis is associated with deficits in regulatory T cells

Cytomegalovirus-specific T-cell reactivity in biliary atresia at the time of diagnosis is associated with deficits in regulatory T cells

A Practical Review of Cytomegalovirus in Gastroenterology and Hepatology

Epidemiology, determinants, and management of AIDS cholangiopathy: A review

Contact Info

Product

Resources

About