A recent retrospective study (W El-Matary et al. JPGN 2018; 67: 221-24) examined the practice of looking for Cytomegalovirus (CMV) in children with a flareup of their inflammatory bowel disease (IBD) which is currently recommended by expert consensus (JPGN 2018; 67: 292-310 –recommendation #3).
- “Four of 61 patients encounters (6.6%) with UC/IBD-U, two with corticosteroid refractory disease, had positive biopsies for CMV by PCR but negative H&E and IHC. They responded to escalated medical therapy, without needing anti-viral therapy.”
- All children who had colectomy during the study did not have CMV detected in colonic mucosa.
The authors note that the rationale for looking for CMV is derived mainly from adult populations. Since age is a known risk factor for CMV reactivation, the risk of CMV causing refractory IBD in children is less.
My take (borrowed in part from authors): “The low frequency of CMV in our study challenges current guidelines that recommend assessment for CMV in all pediatric patients with acute severe UC refractory to corticosteroids.” This issue would be another that would benefit by collecting the experience of a large cohort (eg. ICN).
Related blog posts:
- Will infliximab worsen flare-ups associated with CMV? (Not in this study)
- CMV in IBD: Tissue Matters | gutsandgrowth
- IBD Updates -January 2017 | gutsandgrowth
- Utility of Antiviral Therapy for Cytomegalovirus in the … – gutsandgrowth
Disclaimer: These blog posts are for educational purposes only. Specific dosing of medications (along with potential adverse effects) should be confirmed by prescribing physician. This content is not a substitute for medical advice, diagnosis or treatment provided by a qualified healthcare provider. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a condition.