Detection of Cytomegalovirus in Colonic Mucosa of Children With Inflammatory Bowel Disease
Bibliographic record
Abstract
OBJECTIVES: Although it has been recommended to perform sigmoidoscopy to screen for cytomegalovirus (CMV) reactivation in acute severe colitis, the frequency of CMV reactivation in children with inflammatory bowel disease (IBD) is unknown. The aim of this study was to determine the frequency and management of CMV detection in colonic mucosa of children with IBD. METHODS: In a retrospective study, consecutive IBD patients, <17 years old, with moderate to severe colitis who had sigmoid biopsy specimens evaluated for CMV by hematoxylin and eosin (H&E) staining, immunohistochemistry (IHC), and polymerase chain reaction (PCR) were included. RESULTS: A total of 90 sigmoid biopsies were collected from 67 patient encounters from 58 patients with colitis: 61 patient encounters (91%) with UC/IBD-U including biopsy samples from colectomy specimens of eight patients who had colectomy during the study period. Medication exposure included corticosteroids for 40 (69%) patients, and immunosuppressive agents for 31 (53.4%) patients. Four of 61 patient encounters (6.6%) with UC/IBD-U, two with corticosteroid refractory disease, had positive biopsies for CMV by PCR but negative H&E and IHC. They responded to escalated medical therapy, without needing anti-viral therapy, and none required colectomy over a median duration of follow up of 1.1 year (IQR 1-1.6). CONCLUSIONS: CMV presence is uncommon in colonic mucosa of children with IBD. Studies examining the underlying sero-prevalence of CMV and its role of reactivation of colitis are required to determine if the current recommendation for routine sigmoidoscopy to exclude CMV infection in corticosteroid-refractory acute severe colitis is justified.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".