Abstract
A patients, 51 years old female had been treated with prednisolone (7.5mg/day) and azathioprin (50mg/day) for autoimmune hepatitis. She had been also treated for duodenal ulcer with famotidine. High grade fever continued for 20 days without the evidence of bacterial infection and blood examination showed high titer of cytomegarovirus (CMV) IgG antibody and CMV antigenemia. After the discontinuation of azathioprine, her body temperature become normal and cytomegarovirus antigenemia disappeared.
Endoscopic examination revealed an ulcer at the gastric angle, and gastric erosions on the fornix and the greater curvature. CMV inclusion bodies were recognized in the biopsies from the ulcer edge. CMV was not detected from former gastric biopsy samples which were taken for the examination of Helicobactor pylori. CMV disappeared in biopsy samples with the improvement of gastric ulcer. The clinical course and histopathological findings suggested gastric ulcer was induced by CMV infection.
