Outcomes of Fecal Microbiota Transplantation for Clostridium difficile Infection in Patients with Inflammatory Bowel Disease

Digestive Diseases and Sciences - Fecal microbiota transplantation (FMT) has recently been shown to be a promising therapy for recurrent and refractory Clostridium difficile infections (CDI)...     

Prevalence of Cytomegalovirus Infection in Inflammatory Bowel Disease Patients

PURPOSE Although there has been an increasing number of case reports on inflammatory bowel disease complicated by cytomegalovirus infection, few reports have described its prevalence. The aim of this study was to investigate the prevalence of cytomegalovirus infection in inflammatory bowel disease and clarify the clinicopathologic features of the cases.METHODS We studied 55 biopsy specimens and 39 surgical specimens taken from patients clinically diagnosed as having ulcerative colitis, and 49 biopsy specimens and 30 surgical specimens from patients clinically diagnosed as having Crohns disease. In all cases cytomegalovirus infection was histopathologically examined by means of hematoxylin and eosin and immunohistochemical staining to detect inclusion bodies in specimens.RESULTS Cytomegalovirus infection was confirmed in 1 of 55 biopsy specimens and in 8 of 39 surgical specimens obtained from the cases with ulcerative colitis. No cytomegalovirus inclusion bodies were exhibited in the 49 biopsy specimens and 30 surgical specimens taken from patients with Crohns disease.CONCLUSIONS Cytomegalovirus infection was detected rather frequently (21 percent) in the surgical specimens of ulcerative colitis, and all cases were steroid resistant. The possibility of cytomegalovirus infection should always be taken into account in patients with ulcerative colitis who are resistant to steroid therapy.     

Cytomegalovirus Infection in Patients with Active Inflammatory Bowel Disease

Background  

The reported prevalence of cytomegalovirus (CMV) infection with active inflammatory bowel disease (IBD) is highly variable, and whether CMV negatively impacts the clinical course is controversial.     

Prevalence of Restless Legs Syndrome in Patients with Inflammatory Bowel Disease

Digestive Diseases and Sciences - There has been increased interest in sleep disorders in patients with inflammatory bowel disease (IBD). Studies in North America and Europe reported that the...     

Prevalence of Macrocreatinkinase Type 1 in Patients with Inflammatory Bowel Disease

Macro-creatine-kinases are isoenzymes of creatinine-kinases (CK). They have been classified in two types: type 1 (CK bound to an immunoglobulin) and type 2 (an oligomeric mitochondrial CK). CK type 1 has been found in patients with ulcerative colitis (UC) but not in Crohn’s disease (CD). However, there are no studies evaluating macro-creatinkinase prevalence in inflammatory bowel disease (IBD). We included 159 consecutive patients (72 UC, 85 CD; 2 indeterminate colitis). Creatin-kinase total activity and isoenzymes activities were determined. Twelve (16.7%) patients with UC and one of the two patients with indeterminate colitis had serum macro-creatinkinase type 1 while no CD patients displayed this macromolecule (P < 0,001). Sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio were calculated for ulcerative colitis versus Crohn’s disease diagnosis, being 16.7, 98.9, 92.3, 59, 14.5, and 0.84% respectively. There was no correlation with age, gender, time from diagnosis, associated diseases, concomitant medication or disease activity. In conclusion our data suggests that the presence of macro-CK in IBD favors the diagnosis of ulcerative colitis. Further studies are necessary to understand the significance of this finding in a subset of patients with IBD.     

Prevalence of Methylenetetrahydrofolate Reductase Polymorphisms in Young Patients with Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) has been related to mutations of methylenetetrahydrofolate reductase (MTHFR), a critical enzyme in the metabolism of folate and methionine, both of which are important factors in DNA methylation and synthesis. A mutated MTHFR genotype was associated with increased toxicity of methotrexate treatment. The objective of this study was to verify, in a population of young patients with IBD, the presence of an association among mutations in the MTHFR gene, the incidence of IBD, and the risk of adverse events during the treatment with thiopurines azathioprine (AZA) or 6-mercaptopurine (6MP). Ninety-two patients with IBD were enrolled; 63 were treated with thiopurines; patients and 130 controls were genotyped for MTHFR mutations by PCR-based methods. The incidence of mutations in the MTHFR gene was not different between patients with IBD and control subjects; the mutated genotype was not associated with an increased risk of toxicity during thiopurine treatment. This research was supported by grants from the Italian Ministry of University and Scientific Research and the Italian Ministry of Health.