Cytomegalovirus infection in ulcerative colitis.
OBJECTIVE
Cytomegalovirus (CMV) infection has been reported as an exacerbating factor in inflammatory bowel disease but the relationship between CMV infection and ulcerative colitis (UC) remains unclear. There has been no detailed research to elucidate the clinicopathologic features of CMV infection in UC using surgical specimens. The aim of this study was to investigate the clinicopathologic features of CMV infection in UC patients who had undergone colectomy.


METHODS
Surgical specimens taken from UC patients were examined for CMV infection. The patients were divided into three groups: severe, refractory, and UC-associated dysplasia or cancer according to the operative indications. CMV infection rates were evaluated and a comparison of clinical parameters was made between CMV-positive and CMV-negative patients, and the risk factors for CMV infection were analyzed using multivariate analyses.


RESULTS
It was found that 25% of 32 patients were positive for CMV in the severe UC group; 8.3% of 72 patients were positive for CMV in the refractory UC group. None of the 22 patients was positive for CMV in the UC-associated dysplasia or cancer group. The CMV-positive rate in the severe UC group was significantly higher than that in the other groups (p<0.05). Patients' age at the time of operation was higher in the CMV-positive group than in the CMV-negative group among the patients with severe UC (p<0.01), and age at operation was an independent risk factor for CMV infection.


CONCLUSIONS
CMV is found more frequently in severe UC than refractory UC and UC-associated cancer or dysplasia. Higher age can be a risk factor for CMV infection in patients with severe UC. However, a high steroid dose may not always be a risk factor for CMV infection.
Kojima
Tetsu
T
Department of Surgical Oncology, University of Tokyo Graduate School of Medicine, Tokyo, Japan. kojimat-tky@umin.ac.jp
Watanabe
Toshiaki
T
Hata
Keisuke
K
Shinozaki
Masaru
M
Yokoyama
Tadashi
T
Nagawa
Hirokazu
H
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery / Q000821:virology*; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D004724:Endoscopy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
D000305:Adrenal Cortex Hormones