A 60-year-old woman with rheumatoid arthritis treated with methotrexate for a decade complained of slight epigastric discomfort. A positive cytomegalovirus (CMV) antigenemia test indicated the probability of CMV-related gastrointestinal infection, for which esophagogastroduodenoscopy was performed. Endoscopic findings showed a non-specific duodenal mucosal lesion; however, pathological investigation revealed evidence of CMV duodenitis. There is scarce information on the clinical and pathological features of CMV-related duodenitis, likely due to its low prevalence. CMV infection in the upper gastrointestinal tract should be considered as a differential diagnosis in high-risk individuals, particularly those with symptoms relating to the digestive system. Biopsy examinations are preferable for the definitive diagnosis of CMV gastrointestinal infection, even without specific endoscopic features.

Original languageEnglish
Pages (from-to)319-323
Number of pages5
JournalActa medica Okayama
Issue number5
Publication statusPublished - 2015


  • Antigenemia
  • Cytomegalovirus (CMV)
  • Gastrointestinal infection
  • Methotrexate
  • Opportunistic infection

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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