Colonic perforation due to severe cytomegalovirus disease in granulomatosis with polyangiitis after immunosuppression

Alessandra Soriano, Nazareno Smerieri, Stefano Bonilauri, Loredana de Marco, Alberto Cavazza, Carlo Salvarani

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Granulomatosis with polyangiitis (GPA) is a small-vessel necrotizing granulomatous vasculitis typically involving upper airways, lungs, and kidneys, which may lead to end-organ damage and life-threatening complications. Major infections during GPA course represent a considerable concern in the management of the disease. Cytomegalovirus (CMV) infection and disease are rare but significant complications in the course of GPA being associated with high morbidity and mortality rates. Colonic perforation due to CMV colitis is exceedingly rare and has so far almost exclusively been documented in HIV, renal transplant, and systemic lupus erythematosus patients. We reported the case of a patient affected with upper airways-limited GPA who developed acute renal failure from rapidly progressive glomerulonephritis and then experienced colonic perforation due to CMV colitis a few weeks after immunosuppressive treatment with high-dose steroids and cyclophosphamide (CYC) for remission induction of the disease. We also reviewed the literature on CMV-related gastro-intestinal complications in the course of GPA and discussed contributing factors to severe manifestations of CMV infection and its reactivation.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalClinical Rheumatology
DOIs
Publication statusAccepted/In press - Jan 4 2018

Fingerprint

Granulomatosis with Polyangiitis
Cytomegalovirus
Immunosuppression
Cytomegalovirus Infections
Colitis
Kidney
Remission Induction
Immunosuppressive Agents
Disease Management
Rare Diseases
Glomerulonephritis
Vasculitis
Acute Kidney Injury
Systemic Lupus Erythematosus
Cyclophosphamide
Steroids
HIV
Morbidity
Transplants
Lung

Keywords

  • ANCA-associated vasculitis (AAV)
  • Colonic perforation
  • Cytomegalovirus (CMV)
  • Granulomatosis with polyangiitis (GPA)
  • Immunosuppression

ASJC Scopus subject areas

  • Rheumatology

Cite this

Colonic perforation due to severe cytomegalovirus disease in granulomatosis with polyangiitis after immunosuppression. / Soriano, Alessandra; Smerieri, Nazareno; Bonilauri, Stefano; de Marco, Loredana; Cavazza, Alberto; Salvarani, Carlo.

In: Clinical Rheumatology, 04.01.2018, p. 1-6.

Research output: Contribution to journalArticle

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