Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Mar 14, 2010; 16(10): 1245-1251
Published online Mar 14, 2010. doi: 10.3748/wjg.v16.i10.1245
Specific endoscopic features of ulcerative colitis complicated by cytomegalovirus infection
Hideyuki Suzuki, Jun Kato, Motoaki Kuriyama, Sakiko Hiraoka, Kenji Kuwaki, Kazuhide Yamamoto
Hideyuki Suzuki, Jun Kato, Motoaki Kuriyama, Sakiko Hiraoka, Kenji Kuwaki, Kazuhide Yamamoto, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
Author contributions: Suzuki H contributed to planning, data collection, statistical analysis, and drafting the manuscript; Kato J performed clinical examination, statistical analysis and drafted the manuscript; Kuriyama M contributed to clinical examination and statistical analysis; Hiraoka S performed clinical examination; Kenji Kuwaki performed statistical analysis; Yamamoto K and Kato J contributed to manuscript direction.
Correspondence to: Jun Kato, MD, Department of Gastroenterology and Hepatology, Okayama University Graduate, School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama 700-8558, Japan. katojun@cc.okayama-u.ac.jp
Telephone: +81-86-2357219  Fax: +81-86-2255991
Received: November 14, 2009
Revised: January 20, 2010
Accepted: January 27, 2010
Published online: March 14, 2010
Abstract

AIM: To identify specific colonoscopic findings in patients with ulcerative colitis (UC) complicated by cytomegalovirus (CMV) infection.

METHODS: Among UC patients who were hospitalized due to exacerbation of symptoms, colonoscopic findings were compared between 15 CMV-positive patients and 58 CMV-negative patients. CMV infection was determined by blood test for CMV antigenemia. Five aspects of mucosal changes were analyzed (loss of vascular pattern, erythema, mucosal edema, easy bleeding, and mucinous exudates) as well as five aspects of ulcerative change (wide mucosal defect, punched-out ulceration, longitudinal ulceration, irregular ulceration, and cobblestone-like appearance). Sensitivity, specificity, positive predictive value, and negative predictive value of each finding for CMV positivity were determined.

RESULTS: The sensitivity of irregular ulceration for positive CMV was 100%. The specificity of wide mucosal defect was 95%. Punched-out ulceration and longitudinal ulceration exhibited relatively high sensitivity and specificity (more than 70% for each).

CONCLUSION: Specific colonoscopic findings in patients with UC complicated by CMV infection were identified. These findings may facilitate the early diagnosis of CMV infection in UC patients.

Keywords: Cytomegalovirus, Endoscopic findings, Ulcerative colitis