Severe systemic cytomegalovirus infections in patients with steroid-refractory ulcerative colitis treated by an oral microemulsion form of cyclosporine: Report of two cases

Piton, Gaël; Dupont-Gossart, Anne-Claire; Weber, Audrey; Herbein, Georges; Viennet, G.; Mantion, Georges; Carbonnel, Franck

doi:10.1016/j.gcb.2007.10.010

Cited by 10 publications

(7 citation statements)

References 33 publications

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“…Cytomegalovirus. Cytomegalovirus (CMV) infection and reactivation have been described in patients taking IMT and anti-TNFs [Aberra and Lichtenstein, 2005;Piton et al 2008]. CMV typically causes a subclinical infection, but it can lead to hepatitis, retinitis and disseminated infection.…”

Section: Vaccinementioning

confidence: 99%

Prevention of infection caused by immunosuppressive drugs in gastroenterology

Orlicka

Barnes

Culver

2013

Therapeutic Advances in Chronic Disease

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Immunosuppressive therapy is frequently used to treat gastrointestinal diseases such as inflammatory bowel disease, autoimmune hepatitis, IgG4-related disease (autoimmune pancreatitis and sclerosing cholangitis) and in the post-transplantation setting. These drugs interfere with the immune system. The main safety concern with their use is the risk of infections. Certain infections can be prevented or their impact minimized. Physicians must adopt preventative strategies and should have a high degree of suspicion to recognize infections early and treat appropriately. This article reviews the risk factors for infections, the mechanism of action of immunosuppressive therapy and proposes preventive strategies.

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Section: Vaccinementioning

confidence: 99%

Prevention of infection caused by immunosuppressive drugs in gastroenterology

Orlicka

Barnes

Culver

2013

Therapeutic Advances in Chronic Disease

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“…In a prospective, multicenter study 78.6% (11/14) of patients with steroid‐refractory UC and CMV infection got relief with ganciclovir treatment . Several studies have estimated antiviral efficacy in CMV‐positive steroid‐refractory UC patients, showing that there were varying remission rates among all study groups but the overall remission rate was up to 80.2% (Table ).…”

Section: Efficiency Of Anti‐cmv Treatmentmentioning

confidence: 99%

Cytomegalovirus: A probable cause of steroid‐refractory ulcerative colitis

Xue

Chen

Wang

et al. 2013

J of Digest Diseases

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Cytomegalovirus, regarded as a trigger of several autoimmune diseases, is an opportunistic pathogen. Patients with ulcerative colitis (UC) undergoing steroid treatment are susceptible to this infection. In the presence of cytomegalovirus, inflammation becomes more complex. Patients with active UC who are infected with cytomegalovirus are usually non-responders to steroid, while antiviral drugs could induce remission. Cytomegalovirus should be suggested as a probable cause of steroid-refractory UC based on the clinical data in the literatures.

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“…CMV pneumonitis has been reported in 10 CD patients, as reviewed by Cascio et al (2012), while it is rarer in ulcerative colitis [4,[12][13][14][15][16][17][18][19][20]. Hookey et al reported a similar case to the presented patient, where a 19-year-old student with quiescent CD under therapy with 6-MP, developed CMV pneumonitis with a favorable outcome [21].…”

Section: Discussionmentioning

confidence: 69%

Quiescent Crohn’s Disease in Clinical Remission With 6-Mercaptopurine: A Breeding Ground for CMV Pneumonia as Part of a Viral Infection Domino

Panos

2014

J Med Cases

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Cytomegalovirus (CMV) infection is frequently associated with inflammatory bowel disease (IBD). CMV pneumonitis has been reported infrequently in patients with IBD, while there has been one such report in a patient with quiescent Crohn's disease (CD) under long-term immunosuppressant treatment with 6-mercaptopurine (6-MP). We present an unusual case of a 24-year-old male, with fistulized CD in clinical remission under 6-MP, who presented with fever and increased seropurulent fistulae effusion. Shortly after admission, he presented nonproductive cough, pancytopenia, elevated serum aminotransferases, hypoxemia and bilateral pulmonary reticulonodular infiltrates expanding from basal bronchopulmonary segments towards the hila. Positive CMV IgM/IgG, pp65 antigen and CMV-PCR confirmed the diagnosis of CMV pneumonitis. Enterococcus faecium and faecalis were also separately isolated from cultures of two different, concurrent enterocutaneous fistulae. Successful treatment included antiviral and appropriate antibiotic therapy. A subsequent adenovirus co-infection in this patient, demonstrating a viral domino phenomenon, illustrates the difficulty of establishing a final diagnosis in a complex case.

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Severe systemic cytomegalovirus infections in patients with steroid-refractory ulcerative colitis treated by an oral microemulsion form of cyclosporine: Report of two cases

Cited by 10 publications

References 33 publications

Prevention of infection caused by immunosuppressive drugs in gastroenterology

Prevention of infection caused by immunosuppressive drugs in gastroenterology

Cytomegalovirus: A probable cause of steroid‐refractory ulcerative colitis

Quiescent Crohn’s Disease in Clinical Remission With 6-Mercaptopurine: A Breeding Ground for CMV Pneumonia as Part of a Viral Infection Domino

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