title: Characteristic endoscopic findings and risk factors for cytomegalovirus-associated colitis in patients with active ulcerative colitis.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Yutaka Hirayama, Takafumi Ando, Osamu Watanabe, Ryoji Miyahara, Masanao Nakamura, Hidemi Goto, Department of Gastroenterology and Hepatolgy, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hirayama
authors.affiliation: Yutaka Hirayama, Takafumi Ando, Osamu Watanabe, Ryoji Miyahara, Masanao Nakamura, Hidemi Goto, Department of Gastroenterology and Hepatolgy, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ando
authors.affiliation: Yutaka Hirayama, Takafumi Ando, Osamu Watanabe, Ryoji Miyahara, Masanao Nakamura, Hidemi Goto, Department of Gastroenterology and Hepatolgy, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hirooka
authors.affiliation: Yutaka Hirayama, Takafumi Ando, Osamu Watanabe, Ryoji Miyahara, Masanao Nakamura, Hidemi Goto, Department of Gastroenterology and Hepatolgy, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Watanabe
authors.affiliation: Yutaka Hirayama, Takafumi Ando, Osamu Watanabe, Ryoji Miyahara, Masanao Nakamura, Hidemi Goto, Department of Gastroenterology and Hepatolgy, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Miyahara
authors.affiliation: Yutaka Hirayama, Takafumi Ando, Osamu Watanabe, Ryoji Miyahara, Masanao Nakamura, Hidemi Goto, Department of Gastroenterology and Hepatolgy, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
authors.forename: Masanao
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Yutaka Hirayama, Takafumi Ando, Osamu Watanabe, Ryoji Miyahara, Masanao Nakamura, Hidemi Goto, Department of Gastroenterology and Hepatolgy, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamamura
authors.affiliation: Yutaka Hirayama, Takafumi Ando, Osamu Watanabe, Ryoji Miyahara, Masanao Nakamura, Hidemi Goto, Department of Gastroenterology and Hepatolgy, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
authors.forename: Hidemi
authors.initials: H
authors.lastname: Goto
keywords: Antigenemia; Colonoscopy; Cytomegalovirus; Risk factor; Ulcerative colitis