Diagnostic yield from colon biopsies in patients with inflammatory bowel disease and suspected cytomegalovirus infection

Is it worth it?

Shifa Umar, Kofi Clarke, Farshaad Bilimoria, Mohammad Bilal, Shailendra Singh, Jan Silverman

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Patients with inflammatory bowel disease (IBD) are often immunosuppressed and are at risk for reactivation of latent cytomegalovirus (CMV) infection. We examined the diagnostic yield from colon biopsies in IBD patients with suspected CMV infection. Methods Patients above 18 years of age who underwent testing for CMV on colon biopsies between January 1st, 2012, and December 31st, 2015, were identified from a pathology data base. A positive CMV result was included only if testing included both hematoxylin/eosin staining and immunohistochemistry from two or more biopsy samples. Results One hundred twenty-five patients met the inclusion criteria. Of these, 99 had a diagnosis of IBD: 30 with Crohn’s disease, 63 with ulcerative colitis, and 6 with indeterminate colitis. As regards treatment, 21.2% of the patients had biologic therapy alone, 13.1% received immunomodulators, and 11.1% were treated with combined biologic and immunomodulator therapy within 3 months of the colon biopsy. In addition, 32.3% of the patients were on steroids. Of the 99 IBD patients, only 1 had biopsy-proven CMV colitis. Conclusion The yield from colon biopsies with hematoxylin/eosin staining and immunohistochemistry to test for CMV in IBD flare is very low. Further multicenter studies with large numbers of patients are needed to compare all testing modalities in the same cohort of patients. This may help identify which subgroup of IBD patients are likely to benefit from specific modalities of CMV testing, with potential cost-saving implications.

Original languageEnglish (US)
Pages (from-to)429-432
Number of pages4
JournalAnnals of Gastroenterology
Volume30
Issue number4
DOIs
StatePublished - Jan 1 2017

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Cytomegalovirus Infections
Inflammatory Bowel Diseases
Colon
Biopsy
Cytomegalovirus
Biological Therapy
Immunologic Factors
Colitis
Hematoxylin
Eosine Yellowish-(YS)
Immunohistochemistry
Staining and Labeling
Ulcerative Colitis
Crohn Disease
Multicenter Studies
Steroids
Databases
Pathology
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Umar, Shifa ; Clarke, Kofi ; Bilimoria, Farshaad ; Bilal, Mohammad ; Singh, Shailendra ; Silverman, Jan. / Diagnostic yield from colon biopsies in patients with inflammatory bowel disease and suspected cytomegalovirus infection : Is it worth it?. In: Annals of Gastroenterology. 2017 ; Vol. 30, No. 4. pp. 429-432.
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title = "Diagnostic yield from colon biopsies in patients with inflammatory bowel disease and suspected cytomegalovirus infection: Is it worth it?",
abstract = "Background Patients with inflammatory bowel disease (IBD) are often immunosuppressed and are at risk for reactivation of latent cytomegalovirus (CMV) infection. We examined the diagnostic yield from colon biopsies in IBD patients with suspected CMV infection. Methods Patients above 18 years of age who underwent testing for CMV on colon biopsies between January 1st, 2012, and December 31st, 2015, were identified from a pathology data base. A positive CMV result was included only if testing included both hematoxylin/eosin staining and immunohistochemistry from two or more biopsy samples. Results One hundred twenty-five patients met the inclusion criteria. Of these, 99 had a diagnosis of IBD: 30 with Crohn’s disease, 63 with ulcerative colitis, and 6 with indeterminate colitis. As regards treatment, 21.2{\%} of the patients had biologic therapy alone, 13.1{\%} received immunomodulators, and 11.1{\%} were treated with combined biologic and immunomodulator therapy within 3 months of the colon biopsy. In addition, 32.3{\%} of the patients were on steroids. Of the 99 IBD patients, only 1 had biopsy-proven CMV colitis. Conclusion The yield from colon biopsies with hematoxylin/eosin staining and immunohistochemistry to test for CMV in IBD flare is very low. Further multicenter studies with large numbers of patients are needed to compare all testing modalities in the same cohort of patients. This may help identify which subgroup of IBD patients are likely to benefit from specific modalities of CMV testing, with potential cost-saving implications.",
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Diagnostic yield from colon biopsies in patients with inflammatory bowel disease and suspected cytomegalovirus infection : Is it worth it? / Umar, Shifa; Clarke, Kofi; Bilimoria, Farshaad; Bilal, Mohammad; Singh, Shailendra; Silverman, Jan.

In: Annals of Gastroenterology, Vol. 30, No. 4, 01.01.2017, p. 429-432.

Research output: Contribution to journalArticle

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T1 - Diagnostic yield from colon biopsies in patients with inflammatory bowel disease and suspected cytomegalovirus infection

T2 - Is it worth it?

AU - Umar, Shifa

AU - Clarke, Kofi

AU - Bilimoria, Farshaad

AU - Bilal, Mohammad

AU - Singh, Shailendra

AU - Silverman, Jan

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N2 - Background Patients with inflammatory bowel disease (IBD) are often immunosuppressed and are at risk for reactivation of latent cytomegalovirus (CMV) infection. We examined the diagnostic yield from colon biopsies in IBD patients with suspected CMV infection. Methods Patients above 18 years of age who underwent testing for CMV on colon biopsies between January 1st, 2012, and December 31st, 2015, were identified from a pathology data base. A positive CMV result was included only if testing included both hematoxylin/eosin staining and immunohistochemistry from two or more biopsy samples. Results One hundred twenty-five patients met the inclusion criteria. Of these, 99 had a diagnosis of IBD: 30 with Crohn’s disease, 63 with ulcerative colitis, and 6 with indeterminate colitis. As regards treatment, 21.2% of the patients had biologic therapy alone, 13.1% received immunomodulators, and 11.1% were treated with combined biologic and immunomodulator therapy within 3 months of the colon biopsy. In addition, 32.3% of the patients were on steroids. Of the 99 IBD patients, only 1 had biopsy-proven CMV colitis. Conclusion The yield from colon biopsies with hematoxylin/eosin staining and immunohistochemistry to test for CMV in IBD flare is very low. Further multicenter studies with large numbers of patients are needed to compare all testing modalities in the same cohort of patients. This may help identify which subgroup of IBD patients are likely to benefit from specific modalities of CMV testing, with potential cost-saving implications.

AB - Background Patients with inflammatory bowel disease (IBD) are often immunosuppressed and are at risk for reactivation of latent cytomegalovirus (CMV) infection. We examined the diagnostic yield from colon biopsies in IBD patients with suspected CMV infection. Methods Patients above 18 years of age who underwent testing for CMV on colon biopsies between January 1st, 2012, and December 31st, 2015, were identified from a pathology data base. A positive CMV result was included only if testing included both hematoxylin/eosin staining and immunohistochemistry from two or more biopsy samples. Results One hundred twenty-five patients met the inclusion criteria. Of these, 99 had a diagnosis of IBD: 30 with Crohn’s disease, 63 with ulcerative colitis, and 6 with indeterminate colitis. As regards treatment, 21.2% of the patients had biologic therapy alone, 13.1% received immunomodulators, and 11.1% were treated with combined biologic and immunomodulator therapy within 3 months of the colon biopsy. In addition, 32.3% of the patients were on steroids. Of the 99 IBD patients, only 1 had biopsy-proven CMV colitis. Conclusion The yield from colon biopsies with hematoxylin/eosin staining and immunohistochemistry to test for CMV in IBD flare is very low. Further multicenter studies with large numbers of patients are needed to compare all testing modalities in the same cohort of patients. This may help identify which subgroup of IBD patients are likely to benefit from specific modalities of CMV testing, with potential cost-saving implications.

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