IgA, albumin, and eosinopenia as early indicators of cytomegalovirus infection in patients with acute ulcerative colitis

Abstract

Background: Cytomegalovirus (CMV) infection can significantly complicate and worsen the condition of acute severe ulcerative colitis (UC) patients. We aimed to explore the predictive risk factors to prevent and identify CMV infection at an early stage in acute UC patients. Methods: A total of 115 moderate-to-severe active UC patients from 17 hospitals throughout China were enrolled. Active CMV infection was diagnosed by one of the following: CMV pp65 antigens, CMV IgM antibodies or CMV DNA. We identified the independent risk factors by multivariate analyses. Results: A total of 64 of 115 active UC patients had active CMV infection. Compared to the non-CMV-infected patients, the CMV-infected patients had a tendency to be male and to exhibit abdominal pain; fever; oral ulcers; eosinopenia; low albumin, immunoglobulin (Ig) A, IgM, and IgG levels; increased high-sensitivity C-reactive protein (hsCRP) levels; hyponatremia; pancolonic lesions; initial onset type; severe activity; and glucocorticoid (high-dose) and immunosuppressive agent use (P < 0.05). In further multivariate analyses, the use of high-dose glucocorticoids (OR 13.55, 95% CI 2.49-73.61, P < 0.01) and immunosuppressive agents (OR 11.23, 95% CI 1.05-119.99, P = 0.04) were independent risk factors for CMV infection. A decrease eosinophil and albumin levels were risk factors for CMV infection. With every 0.1*10^9/L decrease in the peripheral blood eosinophil level or 1 g/L decrease in the serum albumin level, the risk for CMV infection in UC patients increased by 5.21-fold (1/0.192) or 1.19-fold (1/0.839), respectively. Conclusions: High-dose glucocorticoid and immunosuppressive agent treatment significantly increase the risk of CMV infection, and correcting eosinopenia and low albumin levels may help prevent CMV infection in UC patients.

Hypoalbuminemia as Surrogate and Culprit of Infections

“…The prognostic value of low serum albumin levels has been demonstrated not only for the development and complications of acute viral, bacterial, and fungal infections [ 95 ], but also for infectious complications in chronic conditions including malignant diseases [ 66 , 96 ], chronic inflammatory diseases [ 97 , 98 ], diabetes [ 95 ], hemodialysis [ 99 ], and solid organ transplantation [ 100 ]. In chronic infectious diseases, hypoalbuminemia is associated with disease reactivation/recurrence and secondary infections [ 101 , 102 , 103 ].…”

PTIP Deficiency in B Lymphocytes Ameliorates Dextran Sulfate Sodium-Induced Ulcerative Colitis in Mice

“…According to our previous study, PTIP contributes to the establishment of steady-state IgG and IgM [10]. Anticommensal IgG activates the FcγR receptor, leading to IL-1b production and aggravation of UC [6]; an increase in IgG levels was observed in the intestinal mucosa from UC patients [20]. However, the function of natural IgM and IgG antibodies in UC is unclear.…”

Clinical Characteristics of Different Human Cytomegalovirus Glycoprotein N Genotypes among Child Patients in China

“…Although some studies have shown a correlation between serum albumin levels and HCMV infection, to the best of our knowledge, this is the first report of a significant association with a specific gN genotype. 28 The results may provide a reference for the exploration of laboratory biomarkers for HCMV infection in different gN genotypes and the assessment of the value of the application of HCMV gN genotype testing.…”