More than 1 million Americans are believed to have ulcerative colitis or Crohn's disease, the most common forms of inflammatory bowel disease. The cause of these conditions is not known, but the most common theory is that the immune system of patients with inflammatory bowel disease reacts abnormally to bacteria in the gut.

"Patients with inflammatory bowel disease are often treated with a combination of immunosuppressive medications to help relieve symptoms," says study coauthor Edward Loftus, MD, Professor of Medicine, Department of Gastroenterology, Mayo Clinic, Rochester, Minn. "Since these medications compromise immune reactions in the body, patients can develop … opportunistic infections."

Dr. Loftus and a team of Mayo Clinic researchers set out to identify and quantify the risk factors that are associated with opportunistic infections in patients with inflammatory bowel disease patients. They studied the medical records of 300 patients with inflammatory bowel disease. One hundred of these patients had contracted opportunistic infections and 200 patients had no history of these infections. The team found that patients aged 50 years or older were 3 times more likely to have infections than younger patients. Additionally, patients on 1 immunosuppressive medication were 3 times more likely to develop opportunistic infections than those on none. Patients on 2 or 3 different immunosuppressive medications were 14 times more likely to develop opportunistic infections than those on none.

"This study shows that patients with inflammatory bowel disease who are on immunosuppressive medications should have a low threshold for seeking medical attention at any sign of infection, such as cough or fever," says Dr. Loftus. "For the medical community, this is another example of the need to be cognizant of the potential risks of combination immunosuppressive therapies."


SOURCE: Mayo Clinic

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