Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-17T20:13:07.812Z Has data issue: false hasContentIssue false

Are children with protein-losing enteropathy after the Fontan operation at increased risk of cytomegalovirus enteropathy? A report of two cases

Published online by Cambridge University Press:  24 January 2020

Christoph Bauer*
Affiliation:
Department for Pediatric Cardiology, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
Gerald Tulzer
Affiliation:
Department for Pediatric Cardiology, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
*
Author for correspondence: C. Bauer, Department for Pediatric Cardiology, Kepler University Hospital GmbH, Johannes Kepler University Linz, 4020Linz, Austria. Tel: 00435768084/28422. E-mail: christoph.bauer@kepleruniklinikum.at

Abstract

Introduction:

Aetiology of protein-losing enteropathy in single-ventricle type CHD is multi-factorial.

Report:

We describe two Fontan patients with protein-losing enteropathy who presented with cytomegalovirus-associated colitis.

Discussion:

Fontan patients display risk factors for cytomegalovirus-induced gastroenteropathy that may affect lymph angiogenesis, disease development, and progression.

Conclusion:

Cytomegalovirus enteropathy may be common among Fontan patients who suffer from protein-losing enteropathy. Polymerase chain reaction is important for detection.

Type
Brief Report
Copyright
© Cambridge University Press 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rychik, J, Atz, AM, Celermajer, DS, et al.Evaluation and Management of the Child and Adult With Fontan Circulation: A Scientific Statement From the American Heart Association. Circulation [Internet]. Juli 2019 [zitiert 30. Juli 2019]; Verfügbar unter: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000696Google Scholar
Biko, DM, Smith, CL, Otero, HJet al.Intrahepatic dynamic contrast MR lymphangiography: initial experience with a new technique for the assessment of liver lymphatics. Eur Radiol 2019; 29(10), 51905196. doi: 10.1007/s00330-019-06112-z.CrossRefGoogle ScholarPubMed
Voigt, S, Schaffrath Rosario, A, Mankertz, A.Cytomegalovirus seroprevalence among children and adolescents in Germany: Data from the German health interview and examination survey for children and adolescents (KiGGS), 2003–2006. Open Forum Infect Dis. 2016; 3(1), ofv193.CrossRefGoogle ScholarPubMed
Megged, O, Schlesinger, Y.Cytomegalovirus-associated protein-losing gastropathy in childhood. Eur J Pediatr 2008; 167(11), 12171220.CrossRefGoogle ScholarPubMed
Ko, J-H, Peck, KR, Lee, WJ, et al.Clinical presentation and risk factors for cytomegalovirus colitis in immunocompetent adult patients. Clin Infect Dis 2015; 60(6), e2026.CrossRefGoogle ScholarPubMed
Adler, SP, Baggett, J, Mcvoy, M.Transfusion-associated cytomegalovirus infections in seropositive cardiac surgery patients. The Lancet 1985; 326(8458), 743746.CrossRefGoogle Scholar
Shimizu, T, Nagata, S, Fujii, T, et al.Enhanced production of interferon-gamma as a possible cause of protein-losing enteropathy after modified Fontan operation. J Pediatr Gastroenterol Nutr 2003; 37(4), 504507.CrossRefGoogle ScholarPubMed
Soderberg-Naucler, C.Does cytomegalovirus play a causative role in the development of various inflammatory diseases and cancer? J Intern Med 2006; 259(3), 219246.CrossRefGoogle ScholarPubMed
Ukarapol, N, Chartapisak, W, Lertprasertsuk, N, et al.Cytomegalovirus-associated manifestations involving the digestive tract in children with human immunodeficiency virus infection. J Pediatr Gastroenterol Nutr 2002; 35(5), 669673.CrossRefGoogle ScholarPubMed
Cakir, M, Ersoz, S, Akbulut, UE.Disseminated cytomegalovirus infection and protein losing enteropathy as presenting feature of pediatric patient with Crohn’s disease. Pediatr Gastroenterol Hepatol Nutr 2015; 18(1), 6065.CrossRefGoogle ScholarPubMed
Fiorentini, S, Luganini, A, Dell’Oste, V, et al.Human cytomegalovirus productively infects lymphatic endothelial cells and induces a secretome that promotes angiogenesis and lymphangiogenesis through interleukin-6 and granulocyte-macrophage colony-stimulating factor. J Gen Virol 2011; 92(Pt 3), 650660.CrossRefGoogle ScholarPubMed
Siciliano, RF, Castelli, JB, Randi, BA, Vieira, RD, Strabelli, TM. Cytomegalovirus colitis in immunocompetent critically ill patients. Int J Infect Dis 2014; 20, 7173. doi: 10.1016/j.ijid.2013.11.008.CrossRefGoogle ScholarPubMed