Characteristic endoscopic findings and risk factors for cytomegalovirus-associated colitis in patients with active ulcerative colitis

• 作者: Hidemi Goto Masanao Nakamura Osamu Watanabe Ryoji Miyahara Takafumi Ando Takeshi Yamamura Yoshiki Hirooka Yutaka Hirayama
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: COLONOSCOPY Risk factor Ulcerative COLITIS ANTIGENEMIA CYTOMEGALOVIRUS
• 年，卷（期）: 2016,（6）
• 页码范围: 301-309
• 页数: 9页
• 分类号: R

摘要

AIM: To identify characteristic endoscopic findings and risk factors for cytomegalovirus (CMV)-associated colitis in patients with active ulcerative colitis (UC).METHODS: A total of 149 UC patients admitted to the Department of Gastroenterology, Nagoya University Hospital, from January 2004 to December 2013 with exacerbation of UC symptoms were enrolled in this retrospective study. All medical records, including colonoscopy results, were reviewed. CMV infection was determined by the presence of CMV antigen, CMV inclusion bodies in biopsy specimens, or positive specific immunohistochemical staining for CMV. Multivariate analysis was used to identify independent risk factors for CMV colitis.RESULTS: Multivariate analysis indicated independent associations with the extent of disease (pancolitis) and In contrast, no association was seen with sex, age at UC diagnosis, immunomodulator use, or infliximab use.Punched-out ulceration was also significantly associated with CMV infection in patients with active UC (odds ratio = 12.672, 95%CI: 4.210-38.143).CONCLUSION: Identification of a total corticosteroid dose > 400 mg for 4 wk, extensive colitis and a specific endoscopic finding of punched-out ulcer might facilitate the more rapid diagnosis and timely initiation of antiviral therapy for CMV-associated colitis in patients with active UC.