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Am J Clin Oncol 2021 Jun 9. Epub 2021 Jun 9.

Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, People's Republic of China Departments of Gastroenterology, Hepatology, and Nutrition Infectious Diseases, Infection Control, and Employee Health Melanoma Medical Oncology Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center Department of Biosciences, Rice University Department of Internal Medicine, Baylor College of Medicine, Houston, TX Department of Internal Medicine, Saint Joseph Hospital, Chicago, IL Department of Internal Medicine, University of Missouri, Kansas City, MO Department of Gastroenterology, Sibley Memorial Hospital, Johns Hopkins University, Washington, DC.

Background And Objective: Immune-mediated diarrhea and colitis (IMDC) is a common adverse event in cancer patients receiving immune checkpoint inhibitors (ICIs). Gastrointestinal (GI) infections can co-occur with IMDC, and its impact on the course and outcome of IMDC remains unclear.

Patients And Methods: We retrospectively reviewed cancer patients who received ICIs and developed IMDC between January 2015 and September 2019. Read More

Clin Case Rep 2021 May 5;9(5):e03600. Epub 2020 Dec 5.

Department of Infectious Diseases Centre Hospitalier Universitaire Brugmann Brussels Belgium.

Suspicion threshold for opportunistic coinfections should be lowered in severe COVID-19. Serum CMV polymerase chain reaction and colonoscopy should be discussed in presence of persistent digestive disturbances. Read More

World J Clin Cases 2021 May;9(15):3726-3732

Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan.

Background: Amebic colitis is an infection caused by and most commonly observed in regions with poor sanitation. It is also seen as a sexually transmitted disease in developed countries. While amebic colitis usually has a chronic course with repeated exacerbations and remissions, it may also manifest as a fulminant form that rapidly progresses and leads to severe, life-threatening complications, such as intestinal perforation, peritonitis, and sepsis, that have a high mortality rate. Read More

Gastroenterol Hepatol (N Y) 2020 Sep;16(9):449-457

Department of Gastroenterology and Hepatology, Kaiser Permanente Medical Group, San Francisco, California.

Hospitalization for inflammatory bowel disease is common and requires coordination of care. The goals of hospitalization are to markedly improve symptoms, transition management to an outpatient regimen, and prevent complications. Initially, providers should determine the phenotype and severity of disease flare and provide optimal medical salvage therapy for induction of disease remission. Read More

Korean J Intern Med 2021 May 30;36(3):751. Epub 2021 Apr 30.

Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea.

Clin Case Rep 2021 Apr 10;9(4):1958-1963. Epub 2021 Feb 10.

Department of Medicine Hamad Medical Corporation Doha Qatar.

Reactivation of cytomegalovirus (CMV) in immunocompetent patients may lead to increase morbidity and mortality. A clinical suspicion allows timely diagnosis, treatment, and favorable outcome. In a subject without apparent risk factors for acute myocardial infarction (AMI), CMV can be a possibility. Read More

Int J Mol Sci 2021 Apr 10;22(8). Epub 2021 Apr 10.

Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.

In physiological conditions, the human intestinal mucosa is massively infiltrated with various subsets of immune cells, the activity of which is tightly regulated by several counter-regulatory factors. One of these factors is transforming growth factor-β1 (TGF-β1), a cytokine produced by multiple cell types and targeting virtually all the intestinal mucosal cells. Binding of TGF-β1 to its receptors triggers Smad2/3 signaling, thus culminating in the attenuation/suppression of immune-inflammatory responses. Read More

Clin J Am Soc Nephrol 2021 Apr 20. Epub 2021 Apr 20.

Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio

Infections remain a common complication of solid-organ transplantation. Most infections in the first month after transplant are typically health care-associated infections, whereas late infections, beyond 6-12 months, are community-acquired infections. Opportunistic infections most frequently present in the first 12 months post-transplant and can be modulated on prior exposures and use of prophylaxis. Read More

Eur J Case Rep Intern Med 2021 29;8(3):002350. Epub 2021 Mar 29.

Department of Gastroenterology and Hepatology, Catharina Ziekenhuis, Eindhoven, The Netherlands.

Case Description: A 28-year old woman receiving thiopurine treatment for Crohn's disease presented with a systemic primo cytomegalovirus (CMV) infection affecting the gut (colitis), liver (hepatitis), lungs (pneumonitis) and eyes (retinitis). Secondary to this systemic infection, she developed splenomegaly, pancytopenia and lymphadenopathy. Anti-viral treatment resulted in complete resolution of clinical, biochemical and radiological abnormalities within 6 weeks. Read More

J Gastrointest Surg 2021 Apr 9. Epub 2021 Apr 9.

Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA.

Ann Agric Environ Med 2021 Mar 19;28(1):56-60. Epub 2020 Mar 19.

Department of Paediatric Gastroenterology and Nutrition, Medical University, Warsaw, Poland.

Introduction: Cytomegalovirus (CMV) infection in patients with inflammatory bowel disease (IBD) is reactivated by the use of immunosuppressive drugs. CMV infection may produce IBD flares refractory to standard therapy.

Objective: The aim of our study was to assess the efficacy and safety of faecal microbiota transplantation (FMT) for the treatment of CMV colitis in patients with ulcerative colitis (UC) flare. Read More

Clin Exp Med 2021 Mar 26. Epub 2021 Mar 26.

Molecular Virology Unit, Microbiology and Virology Department, San Matteo Hospital Foundation, Pavia, Italy.

Human Cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) are endowed with the ability of establishing lifelong latency in human hosts and reactivating in immunocompromised subjects, including patients suffering from ulcerative colitis (UC). We, therefore, aimed to investigate virus-specific immunity in UC patients. A cohort of 24 UC patients (14 responders and 10 refractory to therapy) and 26 control subjects was prospectively enrolled to undergo virus-specific serology (by ELISA assay) and assessment of both CD4 and CD8 virus-specific T-cell response (by interferon-γ enzyme-linked immunospotanalysis). Read More

JGH Open 2021 Mar 16;5(3):377-381. Epub 2021 Feb 16.

Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan.

Background And Aim: Several studies have identified postinduction therapy predictors of long-term outcomes of ulcerative colitis (UC) in patients who experienced the first attack of the disease or relapsed after therapy. We aimed to identify the preinduction therapy predictors at admission that predicted early colectomy in patients with moderate to severe UC.

Methods: Ninety-five patients with moderate to severe UC who underwent induction therapy at the Kyoto Prefectural University of Medicine hospital between August 2008 and March 2020 were retrospectively included and categorized into two groups: the colectomy group ( = 27) and the noncolectomy group ( = 68). Read More

Case Rep Crit Care 2021 19;2021:8811396. Epub 2021 Feb 19.

Nassau University Medical Center-Department of Pulmonary and Critical Care Medicine, USA.

Introduction: Cytomegalovirus (CMV) is a common double-stranded DNA (dsDNA) virus affecting a large majority of the world's population. In immunocompetent patients, CMV infection can range anywhere from an asymptomatic course to mononucleosis. However, in the immunocompromised patient, prognosis can be deadly as CMV can disseminate to the retina, liver, lungs, heart, and GI tract. Read More

Mol Clin Oncol 2021 Apr 8;14(4):65. Epub 2021 Feb 8.

Department of Medical Oncology, Osaka International Cancer Institute, Osaka Prefectural Hospital Organization, Osaka 541-8567, Japan.

The present study investigated outcomes of infliximab (IFX) treatment among 8 Japanese patients with various types of cancer (4 with malignant melanoma, 3 with lung cancer and 1 with renal cancer) who developed severe steroid-resistant immune-related adverse events (irAEs) in association with immune checkpoint inhibitors (ICIs) to determine its efficacy and safety. Information, including patient background, treatment progress, examination data and imaging data, was collected retrospectively from electronic medical records. Adverse reactions were evaluated using the Common Terminology Criteria for Adverse Events version 4. Read More

Clin Res Hepatol Gastroenterol 2021 Mar 1;45(6):101625. Epub 2021 Mar 1.

Le Bonheur Children's Hospital, USA; Department of Pediatrics, Division of Infectious Diseases, USA. Electronic address:

Background: The prevalence and significance of cytomegalovirus (CMV) colitis in pediatric acute severe colitis is unknown. The aim of this study was to determine the prevalence of CMV in colonic mucosa of children with acute severe refractory colitis and compare the clinical characteristics and outcomes of CMV positive and negative patients.

Methods: In a case-control study, colonic biopsy specimens from children with severe refractory colitis were tested for CMV, and matched with non-refractory IBD controls. Read More

J Pediatr Gastroenterol Nutr 2021 Feb 26. Epub 2021 Feb 26.

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA Division of Pathology, Boston Children's Hospital, Boston, MA.

Case Rep Gastroenterol 2021 Jan-Apr;15(1):97-99. Epub 2021 Jan 26.

Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.

Clin Case Rep 2021 Jan 12;9(1):148-152. Epub 2020 Nov 12.

Critical Care Unit Hazm Mebaireek General Hospital (HMGH) Hamad Medical Corporation (HMC) Doha Qatar.

The authors urge clinicians to observe for early signs of CMV reactivation in patients presenting with gastrointestinal bleeding and intestinal perforation after receiving tocilizumab or other immunosuppressive therapy as a treatment for COVID 19. Early recognition of CMV infection and treatment will prevent life-threatening bleeding and mortality. Read More

BMC Surg 2021 Jan 21;21(1):50. Epub 2021 Jan 21.

Department of Surgery, Coloproctology Center Takano Hospital, 3-2 Ooe, Kumamoto, Kumamoto, 862-0971, Japan.

Background: Gastrointestinal lymphomas like diffuse large B-cell lymphoma (DLBCL) are rare complications of ulcerative colitis (UC), and only a few studies have reported intestinal ulcers caused by DLBCL, which got perforated during the treatment of UC.

Case Presentation: A 43-year-old man with severe lower abdominal pain and an 8-year history of UC was admitted in our hospital. He was diagnosed UC since 8 years and received a maintenance oral dose of 5-aminosalicylic acid, and no other immunosuppressive drugs. Read More

Clin J Gastroenterol 2021 Feb 21;14(1):181-186. Epub 2021 Jan 21.

Department of Gastroenterology, National Hospital Organization Kanazawa Medical Center, 1-1 Shimoishibikicho, Kanazawa, Ishikawa, 920-8650, Japan.

Pouchitis is a frequent complication of surgical treatment of ulcerative colitis (UC), and is typically treated using antimicrobials. If pouchitis is refractory to antimicrobials, screening for complications, such as cytomegalovirus (CMV) infection, is necessary. However, the optimal approach to management of pouchitis complicated by CMV infection is unclear. Read More

Dig Dis Sci 2021 Jan 12. Epub 2021 Jan 12.

Division of Gastrointestinal and Oncologic Surgery, Northwestern Medicine, Arkes Family Pavilion, 676 North Saint Clair Street, Suite 650, Chicago, IL, 60611, USA.

Background: Patients with ulcerative colitis (UC) are at increased risk for infections such as Clostridium difficile and cytomegalovirus (CMV) colitis due to chronic immunosuppression. These patients often undergo multiple surgeries putting them at risk for recurrence of the infection. However, rates of recurrence in this setting and outcomes are not well understood. Read More

BMJ Case Rep 2021 Jan 7;14(1). Epub 2021 Jan 7.

Infectious Diseaes Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia.

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, but serious systemic hypersensitivity reaction associated with a range of medications. We present two cases of vancomycin-induced DRESS, which occurred simultaneously in the orthopaedic ward in an outer metropolitan hospital. These cases demonstrate the complexity in the diagnosis and management of this inflammatory syndrome on the background of known infection as well as evidence for linezolid as an alternative to vancomycin. Read More

Aging (Albany NY) 2020 12 22;12(24):24709-24720. Epub 2020 Dec 22.

General Surgery Unit, University Hospital of Catania, Catania 95123, Italy.

Chronic immunosuppression may increase the risk of post-transplant infection and medication-related injury and may also be responsible for the increased risk of gastrointestinal complications in kidney transplant recipients. Differentiating the various forms of post-transplant colitis is challenging, since most have similar clinical and histological features. This study evaluated the incidence of post-transplant gastrointestinal complications during screening colonoscopy. Read More

Zhongguo Zhong Yao Za Zhi 2020 Nov;45(22):5362-5372

the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine Nanning 530023, China.

To explore the mechanism of Sijunzi Decoction in the treatment of ulcerative colitis(UC) based on network pharmacology. The active components and corresponding targets of Sijunzi Decoction were extracted with Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP), and the targets were standardized with the help of Uniprot database. The related targets of UC were obtained through GeneCards database and Disgenet database, and the intersection targets of drugs and diseases were screened by R language. Read More

Zhonghua Yi Xue Za Zhi 2020 Dec;100(44):3504-3509

Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

To analyze the relationship between matrix Gla protein(MGP) and clinical characteristics of patients with ulcerative colitis (UC). Fifty-one UC patients who were admitted to the gastroenterology department of Peking union medical college hospital from July 1, 2015 to May 31, 2017 were included. Twenty-seven healthy subjects in the same period were included as normal controls. Read More

BMC Infect Dis 2020 Nov 11;20(1):828. Epub 2020 Nov 11.

Department of Gastroenterology, Gastrointestinal Oncology, Hepatology, Infectious Diseases and Geriatrics, University Hospital Tübingen, Tübingen, Germany.

Background: Severe and disseminated non-tuberculous mycobacterial (NTM) infections are frequently linked to a genetic predisposition but acquired defects of the interferon gamma (IFNγ) / interleukin 12 (IL-12) pathway need to be considered in adult patients with persistent or recurrent infections. Neutralizing anti-IFNγ autoantibodies disrupting IFNγ signalling have been identified as the cause of a severe and unique acquired immunodeficiency syndrome with increased susceptibility to NTM and other intracellular pathogens.

Case Presentation: An adult Asian female with a previous history of recurrent NTM infections presented with persistent diarrhea, abdominal pain, night sweats and weight loss. Read More

J Gastroenterol 2021 Mar 5;56(3):240-249. Epub 2020 Nov 5.

Division of Surgical and Molecular Pathophysiology, Tohoku University Graduate School of Medicine, Sendai, Japan.

Background And Aim: After colectomy for ulcerative colitis (UC), very severe and sometimes lethal enteritis can develop. However, the clinical features remain uncertain because of the low incidence, diversity of symptoms, and undefined diagnostic criteria. The aim of this study was to define postoperative ulcerative colitis-related severe enteritis (UCRSE) and to investigate its clinical features. Read More

Intest Res 2020 Nov 6. Epub 2020 Nov 6.

Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.

Background/aims: Predictors of short-term outcome of intravenous (IV) steroid therapy in acute severe ulcerative colitis (ASUC) have been well described, but the impact of cytomegalovirus (CMV) infection as a predictor of outcome remains debatable. We investigated the role of quantitative CMV polymerase chain reaction (PCR) as a predictor of short-term outcome in patients with ASUC.

Methods: Consecutive patients with ASUC satisfying Truelove and Witts criteria hospitalized at All India Institute of Medical Sciences (AIIMS) from May 2016 to July 2019 were included; all received IV steroid. Read More

Cureus 2020 Sep 27;12(9):e10688. Epub 2020 Sep 27.

Department of Gastroenterology, Istanbul Medeniyet University, School of Medicine, Istanbul, TUR.

HIV is a global epidemic that needs a multidisciplinary approach. Gastrointestinal bleeding is uncommon in HIV-positive patients. In cases such as bacillary angiomatosis, Kaposi sarcoma, herpes simplex, histoplasmosis, and cytomegalovirus (CMV) colitis, the underlying reason could be HIV. Read More