Abstract

García-Gavilán Maria Carmen*, Fernández-Pérez Francisco, Pereda-Salguero Teresa and Fernández-Sánchez Fernando

ABSTRACT

Introduction: Cytomegalovirus (CMV) is a frequent cause of infection in patients with inflammatory bowel disease (IBD) that has been linked with a poor prognosis. Its diagnosis is currently made by immunohistochemistry staining or polymerase chain reaction (PCR) of intestinal tissue samples. Material and Methods: Retrospective study of patients with IBD and confirmed CMV-colitis, diagnosed from January-2010 to June-2019 at the Costa del Sol Hospital. Risk factors associated to clinically significant colitis (CSC) and colectomy were evaluated. Results: Thirty patients (median of age 49 years), 29 with ulcerative colitis (UC) and one with Crohn´s disease (CD), were included. Most of our patients were immunocompromised (83,3%) due to the use of immunosuppressive medication, and 56,7% showed a steroid-refractory colitis. In 23 out of 30 patients (75.9%) the established criterion for clinically significant colitis was met. Of all patients with CMV-colitis, 89,3% resolved the infection and 7,1% relapsed. At the end of study follow-up, 5 patients (16,7%) required an emergency or scheduled colectomy. Male gender (p = 0.030) and the severe endoscopic activity (p = 0.032) were risk factors for CSC, while malnutrition was the single risk factor related to colectomy (p = 0,003). Conclusions: In our study some patients presented with severe colitis needing antiviral treatment and in others CMV did not seem to have an important prognostic role. Male sex and the endoscopic inflammatory activity were risk factors of CSC. Malnutrition was the only risk factor related to colectomy.