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Review
. 2024 Aug 2;13(8):650.
doi: 10.3390/pathogens13080650.

Cytomegalovirus in Ulcerative Colitis: An Unwanted "Guest"

Danusia Onisor  1   2 , Olga Brusnic  1   2 , Simona Mocan  3 , Mircea Stoian  4 , Calin Avram  5 , Adrian Boicean  6 , Daniela Dobru  1   2
Affiliations
Review

Cytomegalovirus in Ulcerative Colitis: An Unwanted "Guest"

Danusia Onisor et al. Pathogens. .

Abstract

The role of cytomegalovirus (CMV) in the flare-up of ulcerative colitis (UC) is not clearly understood. CMV can cause similar symptoms in different clinical contexts, which may be attributed to the natural evolution of the viral infection, the patient's immune status, or its association with inflammatory bowel disease (IBD). This study aims to delineate the diverse manifestations of CMV-related lesions from clinical, endoscopic, and histopathological perspectives, alongside a brief narrative review of the literature. In managing IBD patients, it is crucial to be vigilant for signs of CMV reactivation, especially before the initiation of more intensive therapies.

Keywords: CMV; diagnostic; treatment; ulcerative colitis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Endoscopic aspects—longitudinal and deep ulcers.
Figure 2
Figure 2
Fragment of colonic mucosa with marked architectural distortion associated with abundant chronic inflammatory infiltrate, including basal plasmacytosis and areas of ulceration (Hematoxylin eosin staining, ×4).
Figure 3
Figure 3
In the area of ulceration, numerous viral inclusions were detected by immunostaining.
Figure 4
Figure 4
Endoscopic aspect—small and deep ulcers.
Figure 5
Figure 5
Immunostaining detected more than five viral inclusions in each fragment.
Figure 6
Figure 6
Endoscopic aspects at a one-year follow-up—pseudopolyps.
Figure 7
Figure 7
Endoscopic findings include erosions and a loss of the vascular pattern (atypical for HCMV colitis).
Figure 8
Figure 8
We identified isolated endothelial cells with viral inclusions in the granulation tissue (Hematoxylin eosin staining, ×40).
Figure 9
Figure 9
HCMV immunostaining pointing out rare viral inclusions in the endothelial cells.
See this image and copyright information in PMC

References

    1. Varani S., Landini M.P. Cytomegalovirus-induced immunopathology and its clinical consequences. Herpesviridae. 2011;2:6. doi: 10.1186/2042-4280-2-6. - DOI - PMC - PubMed
    1. Nakase H., Honzawa Y., Toyonaga T., Yamada S., Minami N., Yoshino T., Matsuura M. Diagnosis and treatment of ulcerative colitis with cytomegalovirus infection: Importance of controlling mucosal inflammation to prevent cytomegalovirus reactivation. Intest. Res. 2014;12:5–11. doi: 10.5217/ir.2014.12.1.5. - DOI - PMC - PubMed
    1. Fisher M.A., Lloyd M.L. A Review of Murine Cytomegalovirus as a Model for Human Cytomegalovirus Disease—Do Mice Lie? Int. J. Mol. Sci. 2021;22:214. doi: 10.3390/ijms22010214. - DOI - PMC - PubMed
    1. Sandford G.R., Brock L.E., Voigt S., Forester C.M., Burns W.H. Rat Cytomegalovirus Major Immediate-Early Enhancer Switching Results in Altered Growth Characteristics. J. Virol. 2001;75:5076–5083. doi: 10.1128/JVI.75.11.5076-5083.2001. - DOI - PMC - PubMed
    1. Krech U. Complement-Fixing Antibodies against Cytomegalovirus in Different Parts of the World. Bull. World Health Organ. 1973;49:103. - PMC - PubMed

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