title: Cytomegalovirus colitis in hospitalized inflammatory bowel disease patients in Taiwan: a referral center study.
abstract: BACKGROUND
  Colitis is exacerbated in patients with concurrent cytomegalovirus (CMV) infection and inflammatory bowel disease (IBD). We assessed the prevalence and clinical features of CMV colitis in hospitalized IBD patients.
  
  
  METHODS
  A retrospective study reviewed the data from January 1, 1998 through December 31, 2013 compiled at the National Taiwan University Hospital. The CMV colitis patients' demographic data, clinical information, treatment regimens, pathologic findings, and outcome were analyzed.
  
  
  RESULTS
  A total of 673 IBD patients were hospitalized during the study period. There were 312 patients diagnosed with Crohn's disease (CD) and 361 with ulcerative colitis (UC). CMV colitis was diagnosed as having positive inclusion bodies in colonic tissue. Six of the 312 CD patients (1.9%) and five of the 361 UC patients (1.4%) were diagnosed with CMV colitis. Compared to CD patients without CMV colitis, patients with CMV colitis were more often older (p < 0.005). Higher steroid usage was noted in the CMV positive group compared to age and gender matched CMV negative IBD patients (81.8% vs. 51.5%). Eight patients received ganciclovir treatment. Three patients who did not receive antiviral treatment had colitis flare-ups after the index admission.
  
  
  CONCLUSIONS
  The prevalence of CMV colitis in hospitalized IBD inpatients was 1.6% in Taiwan. Two associated factors for CMV colitis in hospitalized IBD patients were that they were elderly in CD and were on higher doses of steroids. Routine histopathology studies and/or PCR for refractory colitis patients are suggested to diagnose CMV colitis. Once the diagnosis is made, antiviral treatment is recommended to decrease the colitis relapse rate.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, No. 7 Chung-Shan South Road, Taipei City, Taiwan.|Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.|Department of Chemical Engineering & Materials Science, Yuan-Ze University, Taoyuan, Taiwan.
authors.forename: Meng-Tzu
authors.initials: MT
authors.lastname: Weng
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, No. 7 Chung-Shan South Road, Taipei City, Taiwan.
authors.forename: Chien-Chih
authors.initials: CC
authors.lastname: Tung
authors.affiliation: Department of Pathology and Forensic Medicine, National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan.
authors.forename: Yi-Shuan
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, No. 7 Chung-Shan South Road, Taipei City, Taiwan.|Department of Internal Medicine, West Garden Hospital, Taipei City, Taiwan.
authors.forename: Yew-Loong
authors.initials: YL
authors.lastname: Leong
authors.affiliation: Department of Oncology, National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan.
authors.forename: Ming-Jium
authors.initials: MJ
authors.lastname: Shieh
authors.affiliation: Department of Pathology and Forensic Medicine, National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan.
authors.forename: Chia-Tung
authors.initials: CT
authors.lastname: Shun
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, No. 7 Chung-Shan South Road, Taipei City, Taiwan.
authors.forename: Cheng-Yi
authors.initials: CY
authors.lastname: Wang
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, No. 7 Chung-Shan South Road, Taipei City, Taiwan.
authors.forename: Jau-Min
authors.initials: JM
authors.lastname: Wong
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, No. 7 Chung-Shan South Road, Taipei City, Taiwan. shuchenwei@ntu.edu.tw.
authors.forename: Shu-Chen
authors.initials: SC
authors.lastname: Wei
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003092:Colitis / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D003093:Colitis, Ulcerative / Q000821:virology*; D003106:Colon / Q000821:virology; D003424:Crohn Disease / Q000821:virology*; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Crohn’s disease; Cytomegalovirus colitis; Inflammatory bowel disease; Ulcerative colitis