Pneumatosis Intestinalis Developed due to CMV Infection in a Pediatric Severe Aplastic Anemia Patient after Hematopoietic Stem Cell Transplantation

Abstract

A 10-year old girl diagnosed as severe aplastic anemia was transplanted with peripheral stem cells from a CMV seropositive full matched unrelated donor. The conditioning regi-men consisted of busulfan, fludarabine, and anti-thymocyte globulin (ATG). At D+114, abdominal pain, fever, and blood-tinged watery diarrhea developed. At D+116, pneuma-tosis intestinalis (PI) was detected on simple abdominal X-ray and computed tomography (CT). Ganciclovir was started intravenously because CMV antigenemia was detected at D+117. Two days later, PI sign disappeared on simple abdominal X-ray, and hema-tochezia began to decrease. CMV antigenemia disappeared 10 days after starting ganciclovir. We describe a 10-year old girl with severe aplastic anemia who developed PI in the presence of CMV infection and gastro-intestinal graft-versus-host-disease (GVHD) after allogeneic stem cell transplantation and was treated successfully with ganciclovir.