Department of Infectious Diseases and Clinical Microbiology Clinic, Ankara City Hospital, Ankara, Turkey.
Department of Gastroenterology, Ankara City Hospital, Ankara, Turkey.
Medicine (Baltimore). 2023 Aug 4;102(31):e34463. doi: 10.1097/MD.0000000000034463.
Cytomegalovirus (CMV) is an opportunistic pathogen that exacerbates inflammatory bowel disease (IBD). There are no clear diagnostic criteria for CMV infection in IBD patients. The aim of this study was to evaluate the importance of the diagnosis of CMV infection with CMV-DNA polymerase chain reaction (PCR) in the colonic mucosa and the response to antiviral treatment. We retrospectively analyzed the clinical data of 30 patients with IBD (24 men, 6 women; median age: 42 years) who were hospitalized because of IBD exacerbation and whose samples were assessed by tissue CMV-DNA PCR positivity. Most of the IBD patients had ulcerative colitis (90%). The CMV-DNA PCR median value was 8848 copies/mL of tissue (range 90-242,936 copies/mL). Blood CMV-DNA PCR was found to be positive in a small group (33.3%, 10/30) of tissue CMV-DNA PCR-positive cases. immunohistochemistry tests were positive in only 5 of the 23 patients positive for CMV-DNA PCR in the colonic mucosa, and high remission (25/30, 83.3%) was detected with antiviral therapy. Recurrence of CMV colitis infection was observed in 9 of 25 patients who had remission with antiviral therapy. The tissue CMV-DNA PCR test was found to be more useful than blood CMV-DNA PCR and immunohistochemistry tests for diagnosing CMV colitis, and the tissue CMV-DNA PCR test enabled rapid and appropriate treatment.
巨细胞病毒（CMV）是一种机会性病原体，可加重炎症性肠病（IBD）。目前尚无针对 IBD 患者 CMV 感染的明确诊断标准。本研究旨在评估结肠黏膜 CMV-DNA 聚合酶链反应（PCR）诊断 CMV 感染及其对抗病毒治疗的反应的重要性。我们回顾性分析了 30 例因 IBD 加重而住院的 IBD 患者（24 名男性，6 名女性；中位年龄：42 岁）的临床资料，这些患者的样本经组织 CMV-DNA PCR 阳性评估。大多数 IBD 患者患有溃疡性结肠炎（90%）。CMV-DNA PCR 的中位数为组织 8848 拷贝/mL（范围 90-242,936 拷贝/mL）。组织 CMV-DNA PCR 阳性的患者中，血液 CMV-DNA PCR 阳性的比例较小（33.3%，10/30）。在结肠黏膜 CMV-DNA PCR 阳性的 23 例患者中，仅 5 例免疫组织化学检测阳性，抗病毒治疗后有 25 例患者（83.3%）达到高缓解。接受抗病毒治疗缓解的 25 例患者中，有 9 例出现 CMV 结肠炎感染复发。组织 CMV-DNA PCR 检测在诊断 CMV 结肠炎方面比血液 CMV-DNA PCR 和免疫组织化学检测更有用，组织 CMV-DNA PCR 检测可实现快速、适当的治疗。
