Fukushima J. Med. Sci.,
Vol. 53, No. 1, 2007

[Case Report]

A CASE OF STEROID-REFRACTORY ULCERATIVE COLITIS
COMPLICATED WITH CYTOMEGALOVIRUS PNEUMONIA

SHUZO SATO¹⁾, HIROKO KOBAYASHI¹⁾, RIE SAITO¹⁾,
TOMOMI SASAJIMA¹⁾, HIROSHI ORIKASA¹⁾, HIROSHI WATANABE¹⁾,
HIROMASA OHIRA¹⁾, KAZUHIRO TASAKI²⁾ and MASAFUMI ABE²⁾

¹⁾Department of Internal Medicine II, Fukushima Medical University School of Medicine,
Fukushima, 960-1295, Japan
²⁾Department of Pathology I, Fukushima Medical University School of Medicine,
Fukushima, 960-1295, Japan

(Received September 5, 2006, accepted January 26, 2007)

Abstract: We present a case of late-onset ulcerative colitis (UC) complicated with cytomegalovirus (CMV) pneumonia revealed by autopsy. A 77-year-old woman had a diagnosis of UC, and received high-dose steroids and leukocytapheresis. Then she received ganciclovir because CMV-pp65 antigenemia test revealed positive which suggested systemic or colonic CMV infection. But ganciclovir was discontinued because of thrombocytopenia and liver dysfunction. After that she had interstitial pneumonia and died of a respiratory failure. Autopsy revealed CMV colitis based on UC, and CMV pneumonia with diffuse alveolar damage. Evaluation of CMV infection in patients with steroid-refractory UC should be considered before proceeding with immunosuppressive therapy or surgery, especially in elderly patients.

Key words: ulcerative colitis, cytomegalovirus pneumonia, CMV infection

佐藤秀三，小林浩子，斉藤理恵，折笠博史，佐々島朋美，渡辺浩志，大平弘正，田�葺a洋，阿部正文

Correspondence to: Shuzo Sato, Department of Internal Medicine II, Fukushima Medical University School of Medicine, Fukushima City 960-1295, Japan.
E-mail: shuzo@fmu.ac.jp