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Published on: November 30, 2016
A prospective study of viral and mycoplasma infections in chronic inflammatory bowel disease
H O Kangro1, S K Chong, A Hardiman
1Department of Virology, St. Bartholomew's Hospital, West Smithfield, London, United Kingdom.
Abstract:
Seventy-two children with chronic inflammatory bowel disease were investigated for infections with various viruses and Mycoplasma pneumoniae, Chlamydia psittaci, and Coxiella burnetii to determine whether these pathogens are associated with acute onset exacerbations. Altogether 54 infections were identified serologically, of which 23 (42.6%) were associated with exacerbations. This corresponded to 24.2% of the recorded exacerbations during the study period. The respiratory pathogens accounted for 59.3% of the infections and 43.8% of these were associated with gastrointestinal symptoms. This is consistent with the observation that up to 40% of the exacerbations were associated with symptoms of antecedent or concurrent infection, most commonly involving the respiratory tract. Rubella virus, Epstein-Barr virus, and adenovirus were associated with acute exacerbations in 5 children. Thus, common pathogens were frequently associated with exacerbations and account for a large proportion of the commonly reported symptoms of a concurrent infection. The possible causal relationship between these pathogens and exacerbation of inflammatory bowel disease is discussed. Reactivation of latent herpesviruses was identified in 4 children with active disease and indicates that the converse relationship may also occur.
Insights
Common viral and bacterial infections frequently trigger acute flare-ups in pediatric inflammatory bowel disease (IBD). These infections, particularly respiratory ones, are linked to gastrointestinal symptoms and IBD exacerbations.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Immunology
Background:
- Pediatric inflammatory bowel disease (IBD) exacerbations can be triggered by various factors.
- The role of specific infectious agents in IBD flare-ups requires further elucidation.
Purpose of the Study:
- To investigate the association between infections and acute exacerbations in children with IBD.
- To identify specific pathogens linked to IBD flare-ups and associated symptoms.
Main Methods:
- Serological investigation of 72 children with chronic IBD for viral infections and specific bacterial/atypical pathogens.
- Correlation of identified infections with the occurrence and symptoms of IBD exacerbations.
Main Results:
- 54 infections were identified in 72 children, with 42.6% associated with IBD exacerbations.
- Respiratory pathogens were common, accounting for 59.3% of infections, and often presented with gastrointestinal symptoms.
- Rubella virus, Epstein-Barr virus, adenovirus, and reactivated herpesviruses were implicated in exacerbations.
Conclusions:
- Common viral and bacterial pathogens are frequently associated with acute exacerbations in pediatric IBD.
- Infections, especially respiratory ones, can precipitate IBD flare-ups and contribute to gastrointestinal symptoms.
- The study suggests a potential causal link between specific infections and IBD exacerbations, warranting further investigation.
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