Korean J Helicobacter Up Gastrointest Res.  2019 Mar;19(1):61-64. 10.7704/kjhugr.2019.19.1.61.

Chest Pain in a Renal Transplant Recipient due to Concomitant Cytomegalovirus and Herpes Simplex Virus Esophagitis

Affiliations
  • 1Division of Gastroenterology, Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea. baegmk@gmail.com
  • 2Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
  • 3Department of Pathology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.
  • 4Division of Nephrology, Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.
  • 5Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.

Abstract

Chest pain in kidney transplant patients is usually caused by cardiac or pulmonary problems. However, it may be rarely caused by opportunistic esophageal infections. A 66-year-old female kidney transplant recipient was admitted because of chest pain. She had been treated with high-dose steroid and immunosuppressants for acute T-cell-mediated rejection. Cardiologic and pulmonary evaluations had normal results. Endoscopic examination revealed three clear ulcerative lesions in the esophagus. Histological and immunohistochemical staining of the endoscopic biopsy specimens revealed coinfection of herpes simplex virus and cytomegalovirus. The patient was treated with intravenous ganciclovir for 2 weeks. Her symptoms completely resolved, and follow-up endoscopy revealed complete healing of the previous ulcers. Viral esophagitis should be considered in the differential diagnosis in kidney transplant recipients presenting with chest pain.

Keyword

Chest pain; Cytomegalovirus; Esophagitis; Herpes simplex virus; Kidney transplantation

MeSH Terms

Aged
Biopsy
Chest Pain*
Coinfection
Cytomegalovirus*
Diagnosis, Differential
Endoscopy
Esophagitis
Esophagus
Female
Follow-Up Studies
Ganciclovir
Herpes Simplex*
Humans
Immunosuppressive Agents
Kidney
Kidney Transplantation
Simplexvirus*
Thorax*
Transplant Recipients*
Ulcer
Ganciclovir
Immunosuppressive Agents
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