ABSTRACT
Cytomegalovirus (CMV) infection is a common human viral infection, affecting 40% to 100% of normal adult, especially in the immune compromised patients. CMV infection can produce variable gastrointestinal (GI) diseases in healthy adults, but can cause severe life-threatening illness involving many organs, including lung, retina, central nervous system, liver and GI tract in immunocompromised host. We experienced CMV colitis with colon perforation in a SLE patient during low dose steroid and azathioprine therapy, and she recovered after medical treatment without surgical interventions. A 33-year-old woman was diagnosed as SLE 7 years ago and treated with low dose, immunosuppressive therapy during 6 years. She complained of a severe abdominal pain and hematochezia. She was diagnosed as CMV colitis with colon perforation by pathologic, immunologic and image studies. After medical treatment, such as intravascular ganciclovir, there was progressive medical improvement, but has been a recurrent CMV colitis with lower GI bleeding.
Subject(s)
Adult , Female , Humans , Abdominal Pain , Azathioprine , Central Nervous System , Colitis , Colon , Cytomegalovirus , Ganciclovir , Gastrointestinal Hemorrhage , Gastrointestinal Tract , Hemorrhage , Immunocompromised Host , Liver , Lung , Lupus Erythematosus, Systemic , RetinaABSTRACT
BACKGROUND: Autoimmune thyroid diseases have been shown to occur in association with connective tissue disorders. This study was undertaken to elucidate the prevalence of thyroid autoantibodies and thyroid dysfunction in Korean patients with rheumatoid arthritis (RA). METHODS: We have compared the prevalence of thyroid autoantibodies in 108 RA patients with 81 age-matched controls. Antimicrosomal antibody (AMA) and antithyroglobulin antibody (ATA) were measured by passive hemagglutinin assay. T3, T4, Free T4, and TSH were measured by chemiluminescence method. Rheumatoid factor was measured by nephelometry. Statistical analysis was performed by chi-square, Fisher's exact test, and Pearson correlation test. RESULTS: 1) The presence of AMA/ATA in patients with RA was significantly higher (28.7%/26.7% in 108 patients) than that of controls (11.1%/9.9% in 81 controls). The positive rates of AMA/ATA in female patients were also higher (28.9%/28.9% in 97 patients) than those of female controls (15.5%/12.1% in 58 controls). 2) Thirty three (17.6%) of 187 patients with RA had the abnormalities of thyroid function; 14 (7.5%) revealed subclinical hypothyroidism, 5 (2.7%) revealed biochemical primary hypothyroidism, 7 (3.7%) revealed sick euthyroid syndrome, and 7 (3.7%) revealed hyperthyroidism. CONCLUSION: These results suggest that autoimmune thyroiditis is highly associated with RA in Korean patients, showing the increased prevalence of thyroid autoantibodies and thyroid dysfunctions.