Cytomegalovirus (CMV) infection and CMV disease, although quite rare in immunocompetent hosts, are associated with morbidity and mortality in immunocompromised patients. Because CMV infection is generally associated with high degree immunosuppression, beyond the cases with HIV infection and hematopoietic stem cell or solid organ transplantation, it is rarely seen in milder immunosuppressive states like in rheumatic diseases [1]. The exception is CMV colitis, prevalently seen in patients with inflammatory bowel disease (IBD) even in those not taking potent immunosuppressive agents [2]. Furthermore, there is limited data about upper gastrointestinal CMV disease in patients with rheumatic diseases taking immunosuppressive medication. Here, we describe severe CMV disease with esophagitis, pancytopenia, multiple large vein and catheter-related intracardiac thromboses along with central nervous system (CNS) findings in a case under immunosuppressive medication, previously diagnosed as pauci-immune glomerulonephritis.