Increased prevalence of CMV in colonic biopsies of kids with severe refractory colitis
Written By : Dr. Nandita Mohan
Medically Reviewed By : Dr. Kamal Kant Kohli
Published On 2021-06-11 03:30 GMT | Update On 2021-06-11 03:30 GMT
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Researchers from a recent study have found out that there is increased prevalence of cytomegalovirus in pediatric inflammatory bowel disease patients with acute severe colitis.
The study is published in the Clinics and Research in Hepatology and Gastroenterology.
The prevalence and significance of cytomegalovirus (CMV) colitis in pediatric acute severe colitis is unknown. Viral burden on histopathology is not predictive of response to therapy or long-term outcome.
Hence, Tsega Temtem and colleagues from the Department of Pediatrics, Division of Gastroenterology, University of Tennessee Health Sciences Center, USA conducted the present study to determine the prevalence of CMV in colonic mucosa of children with acute severe refractory colitis and compare the clinical characteristics and outcomes of CMV positive and negative patients.
The authors carried out a case-control study in which colonic biopsy specimens from children with severe refractory colitis were tested for CMV, and matched with non-refractory IBD controls. Furthermore, CMV positive patients were characterized by assessing laboratory values, concurrent medications, and need for surgery as compared with CMV negative refractory colitis patients, explains Temtem.
The following key findings were seen-
Colonic biopsies from 96 patients were evaluated for CMV; 48 with severe refractory colitis, and 48 non-refractory controls.
There was an increased prevalence of CMV in severe refractory colitis [7/48 (14.6%), P < 0.0001]; all were previously CMV negative.
Viral DNA burden on immunohistochemistry was not predictive of response to antiviral therapy or need for surgery at 12 months.
Lymphopenia was seen in all CMV positive patients, but this did not demonstrate statistical significance (P = 0.09).
We did not see an association between azathioprine or infliximab use and the need for surgery at 12 months, says Temtem.
Therefore, the authors concluded that "There is an increased prevalence of CMV in colonic biopsies of pediatric patients with severe refractory colitis. Viral burden does not predict clinical outcomes or subsequent need for colectomy."
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