Refractory Protein-losing Enteropathy Complicated by Cytomegalovirus Enterocolitis after Chemotherapy for Multiple Myeloma: A Fatal Adult Case
Abstract
Protein-losing enteropathy (PLE) complicated by cytomegalovirus (CMV) enterocolitis is rare in adults. We report a fatal case of refractory PLE complicated by CMV enterocolitis after chemotherapy for multiple myeloma. A 71-year-old woman developed severe diarrhea and hypoalbuminemia after a single course of bortezomib-based therapy. CMV enterocolitis was diagnosed by an endoscopic biopsy despite initially negative blood CMV DNA. Although antiviral therapy controlled the CMV infection, PLE and intestinal ulceration persisted, leading to perforation and uncontrollable gastrointestinal bleeding. This case highlights the importance of early consideration of CMV enterocolitis and prompt colonoscopic evaluation in patients with persistent diarrhea and hypoalbuminemia following chemotherapy.
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BibTeX
@article{oura2026refractory,
title = {{Refractory Protein-losing Enteropathy Complicated by Cytomegalovirus Enterocolitis after Chemotherapy for Multiple Myeloma: A Fatal Adult Case}},
author = {Mitsuaki Oura and Yuya Kurihara and Rio Motomura and Michiaki Sato and Arika Shimura and Mitsuhiro Yuasa and Takayuki Tsujimoto and Yoichi Yasunaga and Aya Shinozaki-Ushiku and Mineo Kurokawa},
journal = {Internal Medicine},
year = {2026},
month = sep,
doi = {10.2169/internalmedicine.7695-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7695-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Refractory Protein-losing Enteropathy Complicated by Cytomegalovirus Enterocolitis after Chemotherapy for Multiple Myeloma: A Fatal Adult Case
AU - Mitsuaki Oura
AU - Yuya Kurihara
AU - Rio Motomura
AU - Michiaki Sato
AU - Arika Shimura
AU - Mitsuhiro Yuasa
AU - Takayuki Tsujimoto
AU - Yoichi Yasunaga
AU - Aya Shinozaki-Ushiku
AU - Mineo Kurokawa
PY - 2026
DA - 2026/09/01
JO - Internal Medicine
DO - 10.2169/internalmedicine.7695-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7695-26/_article
AB - Protein-losing enteropathy (PLE) complicated by cytomegalovirus (CMV) enterocolitis is rare in adults. We report a fatal case of refractory PLE complicated by CMV enterocolitis after chemotherapy for multiple myeloma. A 71-year-old woman developed severe diarrhea and hypoalbuminemia after a single course of bortezomib-based therapy. CMV enterocolitis was diagnosed by an endoscopic biopsy despite initially negative blood CMV DNA. Although antiviral therapy controlled the CMV infection, PLE and intestinal ulceration persisted, leading to perforation and uncontrollable gastrointestinal bleeding. This case highlights the importance of early consideration of CMV enterocolitis and prompt colonoscopic evaluation in patients with persistent diarrhea and hypoalbuminemia following chemotherapy.
SN - 1349-7235
SN - 0918-2918
ER -