Toxic Megacolon Associated with Cytomegalovirus Infection in a Patient with Steroid-naïve Ulcerative Colitis

Inoue, Ken; Wakabayashi, Naoki; Fukumoto, Kohei; Yamada, Shinya; Bito, Nobukatsu; Yoshida, Naohisa; Katada, Kazuhiro; Uchiyama, Kazuhiko; Ishikawa, Takeshi; Handa, Osamu; Takagi, Tomohisa; Konishi, Hideyuki; Yagi, Nobuaki; Kokura, Satoshi; Kishimoto, Mitsuo; Yanagisawa, Akio; Naito, Yuji

doi:10.2169/internalmedicine.51.8145

Cited by 9 publications

(11 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Five of these six patients but only 2 of the 40 patients without HCMV infection had TM [4]. Further cases reports described the association between HCMV and TM [5][6][7] but it is not clear if HCMV is more frequent in TM than in severe colitis. …”

Section: Introductionmentioning

confidence: 99%

Toxic megacolon and human Cytomegalovirus in a series of severe ulcerative colitis patients

Criscuoli

Rizzuto

Gallo

et al. 2015

Journal of Clinical Virology

View full text Add to dashboard Cite

a b s t r a c tBackground: Human Cytomegalovirus (HCMV) infection has been reported to be a cause of refractory ulcerative colitis (UC). Toxic megacolon (TM) is a rare but severe complication of an acute attack of UC. Objectives: Aim of this study is to evaluate in a case-control study the association between HCMV and TM. Study design: All patients who were admitted at Medicine Department of V. Cervello Hospital in Palermo (tertiary referral center) for a severe UC flare-up complicated by the onset of TM (diameter of the transverse colon > 6 cm) between January 1990 and November 2011 were identified through the electronic database. A total of 24 consecutive patients (16 male/8 female) with TM were identified. Each case of TM were individually matched by sex, age, extent of the underlying disease to 24 severe UC controls who did not develop TM. A further non matched control population of 48 severe UC was included.Haematoxilin and eosin stain, immunohistochemical procedure and nested polymerase chain reaction were performed to detect HCMV genes and proteins on rectal biopsies or surgical specimens. Pp65 antigenemia was performed in order to diagnose any possible systemic infection. HCMV frequency was compared between patients with and without TM during follow-up, using Fisher's Exact test. Results and conclusions: HCMV was detected in histological specimens of 11 patients (46%) with TM compared to 2 (9%) severe UC matched controls (P = 0.0078) and 7 (14%) unmatched controls (p = 0,003). In severe colitis the presence of HCMV is more frequently associated with TM.

show abstract

Section: Introductionmentioning

confidence: 99%

Toxic megacolon and human Cytomegalovirus in a series of severe ulcerative colitis patients

Criscuoli

Rizzuto

Gallo

et al. 2015

Journal of Clinical Virology

View full text Add to dashboard Cite

show abstract

“…[14][15][16][17][18][19][20][21] In our study CMV was detected in 5 patients who had used only 5-ASA and no immunosuppressant in the past for disease control.…”

Section: Discussionmentioning

confidence: 44%

A retrospective study on clinician's practice on testing and treating for cytomegalovirus infection in patients with acute ulcerative colitis in a tertiary care center in India

Kumar

Mohindra²,

Deep

et al. 2016

Int J Res Med Sci

View full text Add to dashboard Cite

“…Thus far, primary CMV infections have only rarely been reported in patients with UC without concurrent immunosuppressive treatments. To our knowledge, only 5 case reports have been published since February 1998 (Table II) (20)(21)(22)(23)(24), and all cases presented the co-occurrence of CMV colitis. The features of CMV mononucleosis, including fever, atypical lymphocytosis, elevated liver enzymes, and hepatosplenomegaly, were observed in 3 cases (20,21,23).…”

Section: Discussionmentioning

confidence: 99%

“…The features of CMV mononucleosis, including fever, atypical lymphocytosis, elevated liver enzymes, and hepatosplenomegaly, were observed in 3 cases (20,21,23). One of the remaining 2 cases showed protein-losing gastroenteropathy (22), whereas the other had toxic megacolon (24). One case had previously undergone short-term steroid treatment for remission induction therapy (21).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

View full text Add to dashboard Cite

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.

show abstract

Toxic Megacolon Associated with Cytomegalovirus Infection in a Patient with Steroid-naïve Ulcerative Colitis

Cited by 9 publications

References 16 publications

Toxic megacolon and human Cytomegalovirus in a series of severe ulcerative colitis patients

Toxic megacolon and human Cytomegalovirus in a series of severe ulcerative colitis patients

A retrospective study on clinician's practice on testing and treating for cytomegalovirus infection in patients with acute ulcerative colitis in a tertiary care center in India

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

Contact Info

Product

Resources

About