Akademik Veri Yönetim Sistemi
Cocuk Enfeksiyon Dergisi, cilt.12, sa.4, 2018 (Scopus)
Objective: Immunosuppressive therapies increase the risk of opportunistic infections in inflammatory bowel disease (IBD). Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) can remain latent in target cells and reactivate when immunity declines. It has been shown that EBV-associat-ed lymphoproliferative disease, EBV and CMV-associated haemophago-cytic lymphohistiocytosis can develop in IBD under immunosuppressive therapy. The aim of our study was to evaluate CMV and EBV infections at the admission and attack episodes and discuss the clinical findings in our IBD patients. Material and Methods: Fifty-six patients who were diagnosed as IBD in the Pediatric Gastroenterology clinic between January 2013 and January 2018 were evaluated retrospectively. Demographic data of patients, classification of IBD and duration of follow-up were recorded. CMV and EBV serologies at the time of diagnosis of IBD, serology results at the colitis attacks in the follow-up, viral load, the treatments that were used for IBD and viral infection were evaluated. Results: Fifty-five percent of the patients were female, with a mean age of 15.1 ± 4.5 years. 62% of the patients had ulcerative colitis, 30% had Crohn’s disease, and 7% had early-onset IBD. Mean diagnosis age of patients was 11 ± 4.5 years, mean follow-up duration was 45 ± 32 months and mean number of attacks was 2.3 ± 1.8 detected. In the follow-up, EBV PCR positivity was observed in two patients and CMV-associated colitis was observed in two patients during active colitis reactivation periods. Viral serologies were not compatible with acute disease in two patients with cytomegalovirus related colitis. In one patient, CMV DNA positivity was detected in serum and in the other patient, CMV colitis was diagnosed by histopathological examination of the colon biopsy material. Two patients were also recovered after three weeks of ganciclovir and reduction in the immunosuppressive therapy. Conclusion: It has been shown that CMV and EBV infection may be a significant problem in patients with IBD in the follow-up and tissue-level studies are necessary in the disease activation, especially even if CMV serology is negative.