Case report: severe CMV colitis in a patient with follicular lymphoma after chemotherapy

J Med Assoc Thai. 2011 Apr;94(4):498-500.

Abstract

Background: Cytomegalovirus (CMV) can infect immuno-compromised host, especially in HIV and bone marrow transplantation patients. CMV colitis was reported after receiving chemotherapy in a solid tumor and aggressive Non-Hodgkin's lymphoma, but not yet in indolent lymphoma patients.

Case report: In the present report, a 64-year-old woman was re-admitted with watery diarrhea after eight cycles of chemotherapy for Follicular lymphoma. She had hyponatremia, hypokalemia, and hypocalcemia, which were the consequences of severe diarrhea. After two weeks of continuous diarrhea, she was set for colonoscopy, which showed multiple ulcers along the colon. Pathological results were found to be consistent with CMV colitis. Her diarrhea symptom improved after receiving ganciclovir.

Conclusion: CMV colitis could occur in indolent lymphoma patients who receive R-CVP regimen (rituximab, cyclophosphamide, vincristine, and prednisolone). Patients exhibiting severe and prolonged diarrhea should be investigated for definite diagnosis in order to receive proper treatment.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal, Murine-Derived / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Antiviral Agents / therapeutic use
  • Colitis / chemically induced*
  • Colitis / drug therapy
  • Colitis / virology
  • Colonoscopy
  • Cyclophosphamide / administration & dosage
  • Cytomegalovirus / isolation & purification
  • Cytomegalovirus Infections / chemically induced*
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / virology
  • Diarrhea / chemically induced
  • Diarrhea / drug therapy
  • Female
  • Ganciclovir / therapeutic use
  • Humans
  • Lymphoma, Follicular / drug therapy*
  • Middle Aged
  • Prednisolone / administration & dosage
  • Rituximab
  • Treatment Outcome
  • Vincristine / administration & dosage

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Antiviral Agents
  • Rituximab
  • Vincristine
  • Cyclophosphamide
  • Prednisolone
  • Ganciclovir