Detection of cytomegalovirus DNA in fecal samples in the diagnosis of enterocolitis after allogeneic stem cell transplantation

• Published in: Biomedical papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia Vol. 162; no. 3; pp. 227 - 231
• Main Authors: Zavrelova, Alzbeta, Radocha, Jakub, Pliskova, Lenka, Paterova, Pavla, Vejrazkova, Eva, Cyrany, Jiri, Gabalec, Filip, Podhola, Miroslav, Zak, Pavel
• Format: Journal Article
• Language: English
• Published: Czech Republic Palacký University Olomouc, Faculty of Medicine and Dentistry 01-09-2018
• Subjects: Aged; allogeneic stem cell transplantation; cmv enterocolitis; cmv infection; Cytomegalovirus - genetics; Cytomegalovirus - isolation & purification; Cytomegalovirus Infections - diagnosis; DNA, Viral - isolation & purification; Enterocolitis - diagnosis; Enterocolitis - virology; Feces - virology; Female; Hematologic Neoplasms - therapy; Humans; Male; Middle Aged; Retrospective Studies; Stem Cell Transplantation - adverse effects; Transplantation, Homologous; CMV enterocolitis; CMV infection; allogeneic stem cell transplantation
• ISSN: 1213-8118; 1804-7521
• DOI: 10.5507/bp.2018.023

Cytomegalovirus enterocolitis is a rare but potentially life threatening complication after allogeneic stem cell transplantation. Its early diagnosis and treatment are essential for a successful outcome.
To determine the potential benefit of fecal CMV DNA detection in the diagnosis of CMV colitis among stem cell transplant recipients.
Biopsies from the lower gastrointestinal tract, taken during 69 episodes of diarrhea, were compared with fecal samples previously examined for CMV DNA in 45 patients after allogeneic stem cell transplantation.
Six confirmed cases of CMV colitis were observed, with 16 out of 69 (23%) fecal samples proving positive for CMV DNA. Only one positive sample correlated with histologically confirmed CMV colitis, and 15 samples were evaluated as false positive. These results provide a 16.7% sensitivity and 76.2% specificity in the diagnosis of CMV enterocolitis.
The examination of fecal samples for the presence of CMV DNA has very low potential in the diagnosis of CMV enterocolitis after allogeneic stem cell transplantation; therefore, a biopsy of the gastrointestinal mucosa is still warranted for correct diagnosis.