Cytomegalovirus (CMV) infection is reported to be a cause of steroid-refractory ulcerative colitis (UC).
In this study, researchers from the United States search a pathology database for UC patients with a diagnosis of severe colitis between 1992 and 2002. The patients' medical records were reviewed.
The team identified 40 patients with refractory UC. The patients were match with 40 controls who had severe but nonrefractory UC.
An additional 40 patients who had undergone colectomy for reasons other than inflammatory bowel disease were selected as noncolitis controls.
|Cytomegalovirus was not detected in any of the noncolitis controls.|
|American Journal of Surgical Pathology|
The researchers detected CMV inclusions on hematoxylin and eosin (H&E) in 2 of 40 patients with refractory UC. However, immunohistochemistry (IHC) detected CMV in 25% of patients with refractory UC and 3% of patients with nonrefractory UC.
CMV was not detected in any of the noncolitis controls.
Dr Neeraja Kambham's team concluded, "This study provides evidence that unrecognized and therefore untreated CMV infection is significantly associated with steroid-refractory UC".
"IHC is more sensitive than H&E for detection of CMV and should be considered as part of the routine evaluation of steroid-refractory UC patients, before proceeding with other medical or surgical therapy that may be unnecessary once the CMV is treated".