Cytomegalovirus positive ulcerative colitis: A single center experience and literature review

Kopylov, Uri; Sasson, Gila; Geyshis, Bella; Oikawa, Michal Tepperberg; Barshack, Iris; Eliakim, Rami; Ben‐Horin, Shomron

doi:10.4291/wjgp.v4.i1.18

Cited by 17 publications

(5 citation statements)

References 21 publications

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“…CMV may be transiently reactivated and disappear without antiviral therapy. In one study it was noted that those with more severe disease were more likely to be treated with ganciclovir, and were more likely to require either rescue therapy or surgery, despite adequate treatment of CMV . CMV colitis complicating UC leading to acute severe colitis can be challenging to manage.…”

Section: Aims and Methodsmentioning

confidence: 99%

Review article: managing the adverse events caused by anti‐TNF therapy in inflammatory bowel disease

Shivaji

Sharratt

Thomas

et al. 2019

Aliment Pharmacol Ther

128

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Background: Biological therapy is currently widely used to treat IBD. Infliximab, adalimumab and golimumab are currently licensed anti-TNF therapies. Biosimilar anti-TNF monoclonal antibodies are increasingly used. Anti-TNF therapies are widely used and their adverse effects are well characterised, and may cause significant morbidity and mortality in a small proportion of exposed patients. Gastroenterologists need to understand the mechanisms for these effects, recognise these swiftly and manage such events appropriately. Aim:To cover the range of potential adverse reactions as a result of biologic therapy and specifically management of these events. Methods: A Medline and Pubmed search was undertaken. Search terms includedwere "anti-TNF," "infliximab" or "adalimumab" or "golimumab" combined with the keywords "ulcerative colitis" or "Crohn's disease" or "inflammatory bowel disease" and then narrowed to articles containing the keywords "complications," "side effects" or "adverse events" or "safety profile." International guidelines were also reviewed where relevant.Results: Adverse events discussed in this review include infusion reactions, blood disorders and infections (including bacterial, viral, fungal and opportunistic infections) as well as autoimmune, dermatological disorders, cardiac and neurological conditions. Malignancies including solid organ, haematological and those linked to viral disease are discussed. Conclusions:Anti-TNF therapy has wide-ranging effects on the immune system resulting in a spectrum of potential adverse events in a small proportion of patients.Research advances are improving the understanding, recognition and management of these adverse events.

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Section: Aims and Methodsmentioning

confidence: 99%

Review article: managing the adverse events caused by anti‐TNF therapy in inflammatory bowel disease

Shivaji

Sharratt

Thomas

et al. 2019

Aliment Pharmacol Ther

128

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“…Systematic reviews in adults have proposed that anti-CMV treatment may be clinically effective in ASC but there is inconsistency regarding the method of defining CMV infection (64)(65)(66)(67). Recent guidelines report that intestinal CMV disease requires the presence of multiple inclusion bodies on histology and/or positive staining on immunohistochemistry rather than merely positive PCR (68)(69)(70)(71).…”

Section: Initial Managementmentioning

confidence: 99%

Management of Paediatric Ulcerative Colitis, Part 2

Turner

Ruemmele

Orlanski-Meyer

et al. 2018

J. pediatr. gastroenterol. nutr.

192

194

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“…However, spontaneous recovery of acute CMV infection has been shown to occur in an immunocompetent patient with UC (21). Moreover, a recent study reported that mild CMV colitis in patients with UC was cured without antiviral therapy (31). Therefore, the use of antiviral agents for acute CMV infection superimposed on immunocompetent UC should be assessed carefully based on the patient's condition, including disease activity and clinical course.…”

Section: Discussionmentioning

confidence: 99%

Acute cytomegalovirus infection in an immunocompetent patient with ulcerative colitis: A case report

et al. 2019

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Cytomegalovirus (CMV) is a ubiquitous member of the Herpesviridae family that can present with a variety of clinical manifestations, including encephalitis, retinitis, interstitial pneumonia and colitis. These serious symptoms are generally observed as opportunistic infections in immunocompromised hosts, including patients with acquired immunodeficiency syndrome and those receiving steroids and/or immunosuppressants. Symptomatic CMV infections in patients with ulcerative colitis are found in patients treated with steroids and/or immunosuppressants but rarely affect those who are not taking these agents. The present study reported the case of a young patient without concurrent use of immunosuppressive agents for the treatment of ulcerative colitis. The patient presented with acute mononucleosis and colitis caused by primary CMV infection. This was characterized by the presence of atypical lymphocytes and hepatosplenomegaly, elevation of transaminase levels, serology-positive anti-CMV IgM, and CMV antigenemia. Additionally, CMV-positive cells were histologically detected in colonic biopsy specimens. The patient's symptoms and clinical parameters improved following initiation of intravenous ganciclovir. It was concluded that even if patients with ulcerative colitis are not treated with steroids and/or immunosuppressants, significant attention should be paid to acute CMV infections in the context of severe or persistent colonic inflammation.

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Cytomegalovirus positive ulcerative colitis: A single center experience and literature review

Abstract: Gancyclovir-treated patients had a more severe disease and outcome, probably unrelated to antiviral therapy. Immunohistochemistry-CMV-positive patients with mild disease may recover without antiviral therapy.

Cited by 17 publications

References 21 publications

Review article: managing the adverse events caused by anti‐TNF therapy in inflammatory bowel disease

Review article: managing the adverse events caused by anti‐TNF therapy in inflammatory bowel disease

Management of Paediatric Ulcerative Colitis, Part 2

Acute cytomegalovirus infection in an immunocompetent patient with ulcerative colitis: A case report

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