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Umar S, Clarke K, Bilimoria F, et al. Diagnostic yield from colon biopsies in patients with inflammatory bowel disease and suspected cytomegalovirus infection: is it worth it?. Ann Gastroenterol. 2017;30(4):429-432doi: 10.20524/aog.2017.0153.
Umar, S., Clarke, K., Bilimoria, F., Bilal, M., Singh, S., & Silverman, J. (2017). Diagnostic yield from colon biopsies in patients with inflammatory bowel disease and suspected cytomegalovirus infection: is it worth it?. Annals of gastroenterology, 30(4), 429-432. https://doi.org/10.20524/aog.2017.0153
Umar, Shifa, et al. "Diagnostic yield from colon biopsies in patients with inflammatory bowel disease and suspected cytomegalovirus infection: is it worth it?." Annals of gastroenterology vol. 30,4 (2017): 429-432. doi: https://doi.org/10.20524/aog.2017.0153
Umar S, Clarke K, Bilimoria F, Bilal M, Singh S, Silverman J. Diagnostic yield from colon biopsies in patients with inflammatory bowel disease and suspected cytomegalovirus infection: is it worth it?. Ann Gastroenterol. 2017;30(4):429-432. doi: 10.20524/aog.2017.0153. Epub 2017 May 05. PMID: 28655979; PMCID: PMC5479995.
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Ann Gastroenterol. 2017;30(4):429-432. doi: 10.20524/aog.2017.0153. Epub 2017 May 05.

Diagnostic yield from colon biopsies in patients with inflammatory bowel disease and suspected cytomegalovirus infection: is it worth it?.

Annals of gastroenterology

Shifa Umar, Kofi Clarke, Farshaad Bilimoria, Mohammad Bilal, Shailendra Singh, Jan Silverman

Affiliations

  1. Department of Internal Medicine (Shifa Umar).
  2. Division of Gastroenterology, Hepatology and Nutrition (Kofi Clarke, Shailendra Singh).
  3. Department of Pathology (Farshaad Bilimoria, Jan Silverman), Allegheny Health Network, Pittsburgh, PA.
  4. Division of Gastroenterology and Hepatology, University of Texas Medical Branch, Galveston, TX (Mohammad Bilal), USA.

PMID: 28655979 PMCID: PMC5479995 DOI: 10.20524/aog.2017.0153

Abstract

BACKGROUND: Patients with inflammatory bowel disease (IBD) are often immunosuppressed and are at risk for reactivation of latent cytomegalovirus (CMV) infection. We examined the diagnostic yield from colon biopsies in IBD patients with suspected CMV infection.

METHODS: Patients above 18 years of age who underwent testing for CMV on colon biopsies between January 1st, 2012, and December 31st, 2015, were identified from a pathology data base. A positive CMV result was included only if testing included both hematoxylin/eosin staining and immunohistochemistry from two or more biopsy samples.

RESULTS: One hundred twenty-five patients met the inclusion criteria. Of these, 99 had a diagnosis of IBD: 30 with Crohn's disease, 63 with ulcerative colitis, and 6 with indeterminate colitis. As regards treatment, 21.2% of the patients had biologic therapy alone, 13.1% received immunomodulators, and 11.1% were treated with combined biologic and immunomodulator therapy within 3 months of the colon biopsy. In addition, 32.3% of the patients were on steroids. Of the 99 IBD patients, only 1 had biopsy-proven CMV colitis.

CONCLUSION: The yield from colon biopsies with hematoxylin/eosin staining and immunohistochemistry to test for CMV in IBD flare is very low. Further multicenter studies with large numbers of patients are needed to compare all testing modalities in the same cohort of patients. This may help identify which subgroup of IBD patients are likely to benefit from specific modalities of CMV testing, with potential cost-saving implications.

Keywords: Cytomegalovirus; biopsy; immunosuppression; inflammatory bowel disease

Conflict of interest statement

Conflict of Interest: None

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