Inflammatory Bowel Diseases

Skip Navigation LinksHome > May 2013 - Volume 19 - Issue 6 > Looking for Endoscopic Features of Cytomegalovirus Colitis:...
Inflammatory Bowel Diseases:
doi: 10.1097/MIB.0b013e31828075ce
Original Clinical Article

Looking for Endoscopic Features of Cytomegalovirus Colitis: A Study of 187 Patients with Active Ulcerative Colitis, Positive and Negative for Cytomegalovirus

Iida, Takayuki MD*; Ikeya, Kentaro MD*; Watanabe, Fumitoshi MD*; Abe, Jinro MD*; Maruyama, Yasuhiko MD; Ohata, Akihiko MD; Teruyuki, Shimura MD; Sugimoto, Ken MD; Hanai, Hiroyuki MD*

Collapse Box


Background: Cytomegalovirus (CMV) is frequently detected in ulcerative colitis (UC) lesions of steroid-refractory patients. This has led to the suspicion that CMV might cause colitis and steroid refractoriness.

Methods: During 2003 and 2011, 187 consecutive patients were divided into group I (n = 105), corticosteroid-free and thiopurine-free in the past 6 months, and group II (n = 82), all corticosteroid refractory. The combination of serum CMV immunoglobulin (Ig)M, CMV IgG, CMV antigenemia (Ag), and real-time polymerase chain reaction assays were performed to identify CMV(+) patients.

Results: In group I, 79 patients were CMV IgG(+) and 26 patients were CMV IgG(−) and CMV IgM(−). In group II, 61 patients were CMV IgG(+), 1 CMV IgM(+), and 20 CMV IgG(−) and CMV IgM(−). All CMV IgG(+) patients were screened for CMV Ag. In group I, 6 of the 79 CMV IgG(+) patients were CMV Ag(+). In group II, 27 patients were CMV Ag(+). Colonoscopy was performed in all patients before screening for CMV. Similar colonoscopic features including punched out ulcers, geographic ulcers, and irregular ulcers were found in both CMV(+) and CMV(−) patients, without any striking difference between the 2 groups.

Conclusions: CMV reactivation might be encouraged by immunosuppressive drugs, like corticosteroids, immunomodulators, and therefore, patients with UC are at a high risk of CMV reactivation, potentially exacerbating UC. However, this study of 187 patients, CMV(+) and CMV(−), could not find colonoscopic features unique to CMV, except that CMV might be one factor for steroid refractoriness, and UC exacerbation.

© Crohn's & Colitis Foundation of America, Inc.

You currently do not have access to this article.

You may need to:

Note: If your society membership provides for full-access to this article, you may need to login on your society’s web site first.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.