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Intestinal cytomegalovirus infection in patients hospitalized for exacerbation of inflammatory bowel disease: a 10-year tertiary referral center experience.

Published on Jun 1, 2015in European Journal of Gastroenterology & Hepatology2.198
· DOI :10.1097/MEG.0000000000000361
Annika Gauss8
Estimated H-index: 8
,
Simon Rosenstiel1
Estimated H-index: 1
+ 6 AuthorsAnna Zawierucha3
Estimated H-index: 3
Abstract
ObjectivesThis 10-year retrospective cohort study aims to determine the prevalence and risk factors of cytomegalovirus (CMV) infection in inpatients with exacerbated inflammatory bowel disease (IBD).MethodsAll patients admitted to the Department of Gastroenterology of the University Hospital Heidelb
  • References (21)
  • Citations (18)
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References21
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#1M. DelvincourtH-Index: 1
#2Anthony LopezH-Index: 11
Last. Harry Sokol (UPMC: Pierre-and-Marie-Curie University)H-Index: 48
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Summary Background Consequences of latent cytomegalovirus (CMV) infection reactivation on inflammatory bowel disease (IBD) flare, as a flare-worsening factor or simple bystander, are debated. Impact of anti-viral treatment on IBD course is poorly known. Aim To assess the impact of CMV reactivation on patients hospitalised for IBD flare and the effect of anti-viral treatment on IBD flare in patients with CMV reactivation. Methods First, a population of UC patients from Saint-Antoine hospital, in ...
39 CitationsSource
#1Uri KopylovH-Index: 31
#2Noa Eliakim-RazH-Index: 1
Last. Lior H. KatzH-Index: 17
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AIM: To evaluate the impact of antiviral treatment on cytomegalovirus (CMV)-positive ulcerative colitis patients. METHODS: We performed a systematic review and meta-analysis (MA) of comparative cohort and case-control studies published between January 1966 and March 2013. Studies focusing on colectomy series and studies including only less than 3 patients in the treated or non-treated arm were excluded. The primary outcome was colectomy within 30 d of diagnosis. Secondary outcomes included colec...
19 CitationsSource
#1Rinaldo Focaccia Siciliano (USP: University of São Paulo)H-Index: 10
#2Jussara Bianchi Castelli (USP: University of São Paulo)H-Index: 13
Last. Tânia Mara Varejão Strabelli (USP: University of São Paulo)H-Index: 14
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Summary Objectives Cytomegalovirus (CMV) is a ubiquitous virus and its reactivation may lead to CMV end-organ disease (CMV EOD) in immunocompromised patients and also in immunocompetent patients when they are critically ill. We aimed to investigate the frequency and the clinical features of proven CMV EOD in previously non-immunosuppressed patients admitted to our institution. Methods From January 2000 to March 2013, the records of all patients with a histopathological diagnosis of CMV EOD at ou...
22 CitationsSource
Cytomegalovirus (CMV) infection is common in humans. The virus then enters a “latency phase” and can reactivate to different stimuli such as immunosuppression. The clinical significance of CMV infection in inflammatory bowel disease is different in Crohn’s disease (CD) and ulcerative colitis (UC). CMV does not interfere in the clinical course of CD. However, CMV reactivation is frequent in severe or steroid-resistant UC. It is not known whether the virus exacerbates the disease or simply appears...
35 CitationsSource
#1Antonio Cascio (UNIME: University of Messina)H-Index: 33
#2Chiara Iaria (UNIME: University of Messina)H-Index: 14
Last. Walter Fries (UNIME: University of Messina)H-Index: 28
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Summary Background Inflammatory bowel disease (IBD) patients are at increased risk of cytomegalovirus (CMV) reactivation, and although CMV pneumonia may be a fatal disease in IBD patients, little information is available on this issue. The objectives of this study were to identify risk factors for the development of CMV pneumonia in IBD patients and to find useful information to better manage this potentially fatal complication. Methods A computerized search without language restrictions was con...
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#1Sylvie Pillet (University of Lyon)H-Index: 16
#2Bruno Pozzetto (University of Lyon)H-Index: 40
Last. Xavier Roblin (University of Lyon)H-Index: 34
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Cytomegalovirus is a deoxyribonucleic acid virus that infects a large part of the human population; after primary infection, it develops a latent state and can be reactivated, notably after a decrease in host immune defences. In patients with inflammatory bowel diseases, cytomegalovirus is frequently involved, either as an agent of colitis or through local asymptomatic reactivation. Due to the immune context of inflammatory bowel diseases and to the immunosuppressive therapies that are used to t...
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#1Xavier Roblin (University of Lyon)H-Index: 34
#2Sylvie Pillet (University of Lyon)H-Index: 16
Last. Bruno Pozzetto (University of Lyon)H-Index: 40
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97 CitationsSource
Although numerous reports have described inflammatory bowel diseases (IBDs) complicated with cytomegalovirus (CMV) infection, the virus participation as an exacerbating factor remains unclear. The aim of this study was thus to clarify the clinical significance of CMV infection complicating exacerbation and to correlate CMV detection with various characteristics in IBD patients. Sixty-seven colonic biopsies obtained from 53 patients admitted for IBD exacerbation were retrospectively analyzed by r...
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#2Fernando Magro (University of Porto)H-Index: 32
Last. Jean-Frederic Colombel (Mount Sinai Hospital)H-Index: 129
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The treatment of inflammatory bowel disease (IBD) has been revolutionised over the past decade by the increasing use of immunomodulators, mainly azathioprine (AZA)/6-mercaptopurine (6-MP) and methotrexate (MTX), together with the advent of biological therapy. Immunomodulators are being used more often and earlier in the course of the disease.1 The introduction of biologic agents, especially inhibitors of the key proinflammatory cytokine, tumor necrosis factor alpha (TNF-α) initiated a new therap...
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#1Katsuyoshi Matsuoka (Keio: Keio University)H-Index: 28
#2Yasushi IwaoH-Index: 29
Last. Toshifumi Hibi (Keio: Keio University)H-Index: 72
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Cytomegalovirus Is Frequently Reactivated and Disappears Without Antiviral Agents in Ulcerative Colitis Patients
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Cited By18
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#1Steven A. Hendler (Loyola University Medical Center)
#2Grant E. Barber (Stanford University)
Last. Berkeley N Limketkai (UCLA: University of California, Los Angeles)H-Index: 1
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Cytomegalovirus (CMV) infection may complicate ulcerative colitis (UC) or Crohn’s disease (CD) hospitalizations. Studies examining this relationship are often single-center examining short time periods. To quantify the prevalence of CMV and its impact on outcomes among UC and CD hospitalizations over time using nationwide administrative databases. The National Inpatient Sample and Nationwide Readmissions Database were analyzed to calculate CMV prevalence per 1000 UC and CD hospitalizations betwe...
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#1Fadi H. Mourad (AUB: American University of Beirut)H-Index: 20
#2Jana G. Hashash (AUB: American University of Beirut)H-Index: 18
Last. Rupert W. Leong (Concord Hospital)H-Index: 36
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Despite multiple studies, the role of CMV infection in exacerbating the severity of inflammation in ulcerative colitis (UC) and its response to treatment remains debatable. Additionally, the optimal diagnostic tests for CMV infection in the setting of UC relapse and timing of antiviral treatment initiation remain unclear. The challenge faced by gastroenterologists is to differentiate between an acute UC flare and true CMV colitis. It seems that the presence of CMV colitis as defined by the prese...
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#2Christopher A. Lamb (Newcastle University)H-Index: 19
#3Nicholas A. Kennedy (University of Exeter)H-Index: 26
Last. A. Barney Hawthorne (University Hospital of Wales)H-Index: 5
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Ulcerative colitis and Crohn’s disease are the principal forms of inflammatory bowel disease. Both represent chronic inflammation of the gastrointestinal tract, which displays heterogeneity in inflammatory and symptomatic burden between patients and within individuals over time. Optimal management relies on understanding and tailoring evidence-based interventions by clinicians in partnership with patients. This guideline for management of inflammatory bowel disease in adults over 16 years of age...
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#1Shin Ju Oh (Kyung Hee University)H-Index: 2
#2Chang Kyun Lee (Kyung Hee University)H-Index: 18
Last. Hyo Jong Kim (Kyung Hee University)H-Index: 25
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AbstractBackground and aims: The impact of cytomegalovirus (CMV) colitis on long-term outcomes of ulcerative colitis (UC) flares remains controversial.Methods: A total of 257 UC patients with moder...
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#1Ali Y. Fakhreddine (Scripps Health)H-Index: 1
#2Catherine T. Frenette (Scripps Health)H-Index: 15
Last. Gauree G. Konijeti (Scripps Health)H-Index: 5
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Human cytomegalovirus (CMV) is a ubiquitous Herpesviridae virus with a wide spectrum of pathology in humans. Host immunity is a major determinant of the clinical manifestation of CMV and can vary widely in the gastroenterology and hepatology practice setting. Immunocompetent patients generally develop a benign, self-limited mononucleosis-like syndrome whereas gastrointestinal tissue-invasive disease is more frequently seen in immunocompromised and inflammatory bowel disease patients. Additionall...
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#1Anat Yerushalmy-Feler (Tel Aviv Sourasky Medical Center)H-Index: 2
#2Jacqueline Padlipsky (TAU: Tel Aviv University)
Last. Shlomi Cohen (Tel Aviv Sourasky Medical Center)H-Index: 7
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Purpose of Review Cytomegalovirus (CMV) colitis is a relatively common end-organ infectious complication in immunocompromised hosts which negatively affects clinical outcomes. This paper presents the contemporary approaches to the diagnosis and management of CMV colitis and discusses some of the controversies of this condition, focusing on methods of diagnosis.
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#1Li Kredel (Humboldt University of Berlin)H-Index: 5
#2Pamela Mundt (Charité)H-Index: 1
Last. Jan C. Preiß (Humboldt University of Berlin)H-Index: 1
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Purpose The optimal method for detecting CMV colitis in patients with inflammatory bowel disease (IBD) has not been established. We wanted to investigate which diagnostic test would be most accurate when defining CMV colitis rather by the further clinical course than by using another diagnostic modality.
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AbstractObjectives: Cytomegalovirus (CMV) often reactivates in ulcerative colitis (UC). In diagnostics, along with immunohistochemistry (IHC) of colonic biopsies, blood CMV polymerase chain reaction (PCR) is gaining increasing application. We aimed to assess agreement between the density of infected colonic cells by IHC and the viral load in the blood by PCR.Material and methods: We retrospectively identified patients with active UC or indeterminate colitis in whom blood CMV PCR had been perform...
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#1Anat Yerushalmy-Feler (TAU: Tel Aviv University)H-Index: 2
#2Sharona Kern-Isaacs (TAU: Tel Aviv University)H-Index: 1
Last. Shlomi Cohen (TAU: Tel Aviv University)H-Index: 5
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Purpose of Review Patients with inflammatory bowel disease (IBD) are predisposed to infections. Cytomegalovirus (CMV) colitis in adult IBD patients, particularly ulcerative colitis (UC), is related to severe or steroid-refractory disease. The aim of this review is to summarize the data on the prevalence and role of CMV colitis in children with IBD.
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#1Meng-Tzu Weng (NTU: National Taiwan University)H-Index: 6
#2Chien-Chih Tung (NTU: National Taiwan University)H-Index: 5
Last. Shu-Chen Wei (NTU: National Taiwan University)H-Index: 24
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Colitis is exacerbated in patients with concurrent cytomegalovirus (CMV) infection and inflammatory bowel disease (IBD). We assessed the prevalence and clinical features of CMV colitis in hospitalized IBD patients. A retrospective study reviewed the data from January 1, 1998 through December 31, 2013 compiled at the National Taiwan University Hospital. The CMV colitis patients’ demographic data, clinical information, treatment regimens, pathologic findings, and outcome were analyzed. A total of ...
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