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Severe acute colitis associated with CMV: a prevalence study.

V Criscuoli¹, A Casà, A Orlando

¹Department of General Medicine and Pneumology, University of Palermo, Palermo, Italy.

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

|January 14, 2005

Summary

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Cytomegalovirus (CMV) is often found in patients with inflammatory bowel disease (IBD) flares. However, this study suggests CMV may only play an incidental role in acute severe colitis, not always requiring antiviral treatment.

Area of Science:

Gastroenterology
Virology
Immunology

Background:

Cytomegalovirus (CMV) is implicated in inflammatory bowel disease (IBD) flares when detected in colonic tissue.
Understanding CMV's role in IBD is crucial for effective patient management.

Purpose of the Study:

To ascertain the prevalence of CMV infection in patients with acute severe colitis.
To evaluate the clinical significance and pathogenic role of CMV in this patient cohort.

Main Methods:

A consecutive series of 42 patients with acute severe colitis (38 ulcerative colitis, 4 Crohn's disease) were studied.
Proctoscopy, colonic biopsies, and blood samples for CMV detection were performed upon admission.
CMV status was assessed regardless of steroid resistance.

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Main Results:

The overall prevalence of CMV infection was 21.4% (9/42) in the study population.
CMV was detected in colonic biopsies in 16.6% (7/42) of patients.
CMV detection in biopsies did not consistently predict steroid resistance; three patients responded to conventional therapy without antivirals, suggesting an incidental role.

Conclusions:

CMV is frequently associated with colitis, but its pathogenicity is variable.
The incidental role of CMV in some cases of acute severe colitis warrants further investigation.
Genotyping studies may elucidate the diverse biological behavior of CMV in IBD.