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Cholestasis,ascites and pancytopenia in an immunocompetent adult with severe cytomegalovirus hepatitis
Authors:Jun-Yan Qian  Xiao-Yin Bai  Yun-Lu Feng  Wen-Jia Zhu  Fang Yao  Jing-Nan Li  Ai-Ming Yang  Fang Li  Jia-Ming Qian
Abstract:Human cytomegalovirus (CMV) is a herpesvirus, which establishes lifelong latency after primary infection and leads to severe disease in immunocompromised patients. However, CMV infection in immunocompetent patients is usually asymptomatic and severe organ damage is rarely reported. We report a case of severe CMV hepatitis in an immunocompetent patient presenting with cholestasis, portal hypertension-related ascites and pancytopenia. The patient was asymptomatic with normal liver function and negative CMV DNA after two weeks of antiviral therapy. This case is an example of a common infection with an uncommon presentation, and suggests that testing for CMV should be carried out, even in patients with normal immune status, presenting with severe liver damage or cholestasis.
Keywords:Cytomegalovirus hepatitis   Cholestasis   Ascites   Pancytopenia   Immunocompetent adult
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