| Theme |
How Do You Choose Treatment Strategies for IBD Patients with a Critical Situation? |
| Title |
Diagnosis and Therapeutic Strategies for Ulcerative Colitis with Cytomegalovirus Infection -- From the Viewpoint of Active Diagnosis and Treatment of Concomitant Cytomegalovirus Infection |
| Author |
Minoru Matsuura |
Department of Gastroenterology and Hepatology, Kyoto University Hospital |
| Author |
Yusuke Honzawa |
Department of Gastroenterology and Hepatology, Kyoto University Hospital |
| Author |
Hiroshi Nakase |
Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University |
| [ Summary ] |
Cytomegalovirus (CMV) infection persists throughout the lifespan in a latent state after primary infection. In patients with ulcerative colitis (UC), particularly those who are treated with corticosteroids and immunomodulatory agents, CMV is often reactivated. In addition, CMV infection occurs even in UC patients who have never been treated with immunosuppressive agents. CMV infection exacerbates colitis and sometimes leads to resistance to medical treatment and significant clinical morbidity in patients with UC. However, the exact role of concomitant CMV infection in the pathophysiological mechanism of UC remains unclear. Optimal control of colonic inflammation and withdrawal of corticosteroids therapy are important in the management of UC patients who are refractory to conventional immunosuppressive therapies and have concomitant CMV infection. In addition, anti‒viral therapy is effective for controlling colonic inflammation in some populations of such UC patients. Active diagnosis and intensified treatment for controlling colonic inflammation are required in the management of patients with UC and concomitant CMV infection. |