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2016 ; 8
(6
): 301-9
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Characteristic endoscopic findings and risk factors for
cytomegalovirus-associated colitis in patients with active ulcerative colitis
#MMPMID27014426
Hirayama Y
; Ando T
; Hirooka Y
; Watanabe O
; Miyahara R
; Nakamura M
; Yamamura T
; Goto H
World J Gastrointest Endosc
2016[Mar]; 8
(6
): 301-9
PMID27014426
show ga
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 use of > 400 mg corticosteroids for the
previous 4 wk. 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.