Q Buck et al. JPGN 2022; 75: 462-465. Routine Histology-Based Diagnosis of CMV Colitis Was Rare in Pediatric Patients

Key findings from this retrospective review (2011-2019):

• Of 1801 cases of histologic colitis, 11 patients had CMV found by histology (mean age 15.4, 72.7% female), with an incidence of 0.6%
• Nine out of these 11 (81.8%) patients were immunocompromised and 4 (36.4%) had inflammatory bowel disease (IBD) as an underlying diagnosis of whom 2 had new-onset ulcerative colitis
• 5 of 6 post-transplant patients with CMV colitis had preexisting CMV viremia
• An independent analysis of 54 consecutive IBD-associated colectomy cases at TCH showed no histologic evidence of CMV

The study finding that half of the cases of CMV in the IBD population were identified prior to treatment indicates that the underlying IBD may be a more important susceptibility factor than the immunosuppressive medications.

My take: This study indicates that CMV colitis remains important in the post-transplant population but is rarely consequential in the pediatric IBD population.

Related blog posts:

• Is it really necessary to check for Cytomegalovirus in Children with Inflammatory Bowel Disease?
• CMV in IBD: Tissue Matters
• IBD Updates -January 2017 With regard to CMV and IBD, this study showed “that in most cases the virus is nonpathogenic and thus antiviral is usually ineffective”
• Utility of Antiviral Therapy for Cytomegalovirus in the … – gutsandgrowth
• Will infliximab worsen flareups associated with CMV?
• Utility of Antiviral Therapy for Cytomegalovirus in the … – gutsandgrowth
• Will infliximab worsen flareups associated with CMV?

Disclaimer: This blog, gutsandgrowth, assumes no responsibility for any use or operation of any method, product, instruction, concept or idea contained in the material herein or for any injury or damage to persons or property (whether products liability, negligence or otherwise) resulting from such use or operation. These blog posts are for educational purposes only. Specific dosing of medications (along with potential adverse effects) should be confirmed by prescribing physician.  Because of rapid advances in the medical sciences, the gutsandgrowth blog cautions that independent verification should be made of diagnosis and drug dosages. The reader is solely responsible for the conduct of any suggested test or procedure.  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.