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  • Title: Cytomegalovirus colitis in patients without inflammatory bowel disease: a single center study.
    Author: Kim CH, Bahng S, Kang KJ, Ku BH, Jo YC, Kim JY, Chang DK, Son HJ, Rhee PL, Kim JJ, Rhee JC, Kim YH.
    Journal: Scand J Gastroenterol; 2010 Nov; 45(11):1295-301. PubMed ID: 20568970.
    Abstract:
    OBJECTIVE: Cytomegalovirus (CMV) aggravates preexisting inflammatory bowel disease (IBD), and there are numerous reports of CMV colitis in IBD patients. However, little attention has been paid to CMV colitis in non-IBD patients. The aim was to determine the clinical manifestations, endoscopic appearance, and clinical course of CMV colitis in non-IBD patients. MATERIAL AND METHODS: We reviewed medical records of patients diagnosed with CMV colitis based on immunohistochemical studies of biopsy specimens or surgical specimens between 1998 and 2009. RESULTS: The medical records of 43 patients were reviewed. Subjects included individuals with AIDS, and those undergoing chemotherapy, steroid therapy, or transplantation, as well as individuals with other co-morbidities and individuals with no previous illnesses. Frequent symptoms were non-bloody diarrhea, abdominal pain, fever, and hematochezia. Macroscopically normal rectosigmoid mucosa was observed in eight of 21 patients who underwent full-length colonoscopy. Endoscopic findings were varied, and included macroscopically normal (n = 2), colitis alone (n = 12), ulcer alone (n = 5), and ulcer with colitis (n = 22). The ulcer margin was well-circumscribed in 12 of 21 patients. Thirty-six patients were administered antiviral agents and two patients died. All patients who were not treated with an antiviral agent recovered spontaneously while waiting for their biopsy results. CONCLUSIONS: Colonoscopy is preferred to sigmoidoscopy for diagnosis of CMV colitis. Antiviral therapy should not be mandatory for a subset of patients with CMV colitis.
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