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Case Reports
. 2015 Nov 21;21(43):12505-9.
doi: 10.3748/wjg.v21.i43.12505.

Cholestasis, ascites and pancytopenia in an immunocompetent adult with severe cytomegalovirus hepatitis

Jun-Yan Qian  1 , Xiao-Yin Bai  1 , Yun-Lu Feng  1 , Wen-Jia Zhu  1 , Fang Yao  1 , Jing-Nan Li  1 , Ai-Ming Yang  1 , Fang Li  1 , Jia-Ming Qian  1
Affiliations
Case Reports

Cholestasis, ascites and pancytopenia in an immunocompetent adult with severe cytomegalovirus hepatitis

Jun-Yan Qian et al. World J Gastroenterol. .

Abstract

Human cytomegalovirus (CMV) is a herpesvirus, which establishes lifelong latency after primary infection and leads to severe disease in immunocompromised patients. However, CMV infection in immunocompetent patients is usually asymptomatic and severe organ damage is rarely reported. We report a case of severe CMV hepatitis in an immunocompetent patient presenting with cholestasis, portal hypertension-related ascites and pancytopenia. The patient was asymptomatic with normal liver function and negative CMV DNA after two weeks of antiviral therapy. This case is an example of a common infection with an uncommon presentation, and suggests that testing for CMV should be carried out, even in patients with normal immune status, presenting with severe liver damage or cholestasis.

Keywords: Ascites; Cholestasis; Cytomegalovirus hepatitis; Immunocompetent adult; Pancytopenia.

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Figures

Figure 1
Figure 1
Findings on imaging. PET (A), transverse CT (B), PET/CT fusion image (C) and maximum intensity projection (MIP, D) image of the whole body using fluorodeoxyglucose PET/CT (FDG PET/CT) demonstrate a large hypermetabolic deposit in the liver (standardized uptake value - SUVmax = 8.3 cm2/mL). PET: Positron emission tomography; CT: Computed tomography.
Figure 2
Figure 2
Biomedical profile during hospitalization. The graph shows the changing pattern of body temperature (T), alanine aminotransferase (ALT), direct bilirubin (DBil) and platelet count (PLT) before and after antiviral therapy.
See this image and copyright information in PMC

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