CMV Colitis Rarely Identified

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.

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Little O’Malley Peak Trail, near Anchorage AK.
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