What question did this study set out to answer?

To report a case of CMV viremia and suspected pneumonitis associated with upadacitinib in ulcerative colitis.

April 8, 2026Open Access

First Reported Case of Upadacitinib-Associated Cytomegalovirus Viremia and Suspected Pneumonitis in Ulcerative Colitis

WJWilfredo Jhoel Javier-RojasHCA Healthcare ANAlvin Boyd Newman-CaroFlorida Center for Gastroenterology MGMamoon GhellaiHCA Healthcare

Key Points

To report a case of CMV viremia and suspected pneumonitis associated with upadacitinib in ulcerative colitis.
Described a patient's medical history and symptoms
Administered upadacitinib as part of treatment for moderate ulcerative colitis
Monitored for signs of CMV reactivation
Provided antiviral therapy following detection of CMV viremia
Patient developed CMV viremia 4 weeks after starting upadacitinib
Suspected pneumonitis diagnosed alongside viremia
Clinical and virologic resolution achieved with antiviral therapy
Case highlights risk of CMV-related complications in patients on JAK inhibitors.

Abstract

Abstract Cytomegalovirus (CMV) reactivation is a clinically important risk in patients with inflammatory bowel disease, particularly those receiving systemic immunosuppression or Janus kinase (JAK) inhibitor therapy, which can impair immunity. JAK inhibitors, including upadacitinib, may predispose patients to opportunistic viral infections. We report a patient with moderate ulcerative colitis who developed CMV viremia with suspected CMV pneumonitis 4 weeks after starting upadacitinib. Antiviral therapy led to clinical and virologic resolution. This case broadens the spectrum of CMV-related complications associated with JAK inhibition and underscores the importance of maintaining vigilance for systemic viral reactivation in inflammatory bowel disease patients receiving immunosuppressive therapy.

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