Cytomegalovirus (CMV) infection in immunocompromised patients is associated with significant morbidity, mortality, and adverse clinical outcome. However, CMV infection in immunocompetent patients has been considered to have subclinical and self-limited course, and does not require treatment. We reports a case of CMV colitis, presented with colon perforation and lower gastrointestinal bleeding in a immunocompetent 31-year-old young male. After conservative treatment, colonoscopy revealed multiple ulcers in transverse colon. CMV colitis was confirmed by microscopic findings and immunohistochemistry. After successful treatment with ganciclovir, the patient improved without invasive procedure.

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• Gastric Ulcers with Cytomegalovirus Infection in an Immunocompetent Patient
  Tae Oh Kim, Ki-Nam Shim, Sang Yoon Kim, Ji Young Lim, A Reum Choe, Chung Hyun Tae, Chang Mo Moon, Seong-Eun Kim, Hye-Kyung Jung, Sung-Ae Jung
  The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2019; 19(4): 277.     CrossRef
• Conservative treatment of cytomegalovirus colitis with bowel perforation in an immunocompetent patient: case report and review of literature
  Kyoung Sik Nam, Hee Ug Park, Min Gi Park, Su Ho Park, Ji Yeon Hwang, Dong Kyu Kim, Sung Jun Kim
  Yeungnam University Journal of Medicine.2017; 34(1): 75.     CrossRef

Nephrotic syndrome is most commonly observed in membranous lupus nephritis in patients with systemic lupus erythematosus (SLE). However, other forms of idiopathic nephrotic syndrome rarely occur in these patients. Here, we report a case of SLE complicated by minimal change disease (MCD). A 24-year-old woman with SLE visited our hospital for generalized edema and heavy proteinuria. Laboratory tests did not support immunological exacerbation of lupus, while renal biopsy revealed diffusely effaced foot processes without electron-dense deposits that were consistent with MCD. Administration of high-dose corticosteroids and 6 subsequent cycles of monthly intravenous cyclophosphamide resulted in complete remission. Although nephrotic-range proteinuria recurred 1 month after switching to maintenance therapy with mycophenolate mofetil, complete remission was reestablished after a 6-month treatment with corticosteroids and cyclosporine. Physicians should be cautious in assessment and management of such a rare renal manifestation.

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• A Unique Cause of Proteinuria in Pregnancy: Class II Lupus Nephritis with Concomitant Minimal Change Disease
  Ryan Kunjal, Rabie Adam-Eldien, Raafat Makary, Francois Jo-Hoy, Charles W. Heilig
  Case Reports in Nephrology and Dialysis.2016; 6(3): 101.     CrossRef