| Theme |
How Do You Choose Treatment Strategies for IBD Patients with a Critical Situation? |
| Title |
Diagnosis of and Therapeutic Strategy for Cytomegalovirus Infection Complicating Ulcerative Colitis : from the Viewpoint of the Limited Role of Antiviral Therapy |
| Author |
Katsuyoshi Matsuoka |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| Author |
Mamoru Watanabe |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| [ Summary ] |
Ulcerative colitis can be complicated by cytomegalovirus (CMV) colitis, which may further contribute to resistance to medical treatment of ulcerative colitis. "CMV infection" and "CMV disease" should clearly be distinguished. However, this is often difficult in patients with ulcerative colitis because of preexisting bowel damage and symptoms. At present, CMV immunohistochemistry and mucosal CMV polymerase chain reaction assay are reported to be the most specific diagnostic tests for CMV colitis complicating ulcerative colitis, although evidence is not sufficient. As intestinal inflammation and immunosuppression can cause CMV reactivation, controlling inflammation can suppress CMV reactivation. The primary therapeutic strategy should therefore be to control the intestinal inflammation of ulcerative colitis, and the indication of anti‒CMV drug should be carefully considered. |