FATAL INFECTIOUS-MONONUCLEOSIS - A SEVERE COMPLICATION IN THE TREATMENT OF CROHNS-DISEASE WITH AZATHIOPRINE

被引:74
作者
POSTHUMA, EFM
WESTENDORP, RGJ
VEER, AVDS
KLUINNELEMANS, JC
KLUIN, PM
LAMERS, CBHW
机构
[1] LEIDEN UNIV HOSP,DEPT INTENS CARE,LEIDEN,NETHERLANDS
[2] LEIDEN UNIV HOSP,DEPT HAEMATOL,LEIDEN,NETHERLANDS
[3] LEIDEN UNIV HOSP,DEPT PATHOL,2333 AA LEIDEN,NETHERLANDS
关键词
CROHNS DISEASE; AZATHIOPRINE; FATAL INFECTIOUS MONONUCLEOSIS;
D O I
10.1136/gut.36.2.311
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
A 19 year old man with a history of Crohn's disease treated with azathioprine and prednisone, died after a primary infection with Epstein-Barr virus. He had the characteristics of the virus associated haemophagocytic syndrome, a rare complication of viral infections, which consists of fever, constitutional symptoms, hepatosplenomegaly, liver function and coagulation abnormalities, and hypertriglyceridaemia. Additionally, there was pain, cytopenia, and histiocytic hyperplasia in the bone marrow, spleen, or lymph nodes. This severe complication has been reported previously in renal transplant patients, but not in those with inflammatory bowel disease taking azathioprine. The immunosuppressive therapy may have contributed to this fatal complication of infectious mononucleosis, and this complication should be considered when treating a patient with inflammatory bowel disease with azathioprine.
引用
收藏
页码:311 / 313
页数:3
相关论文
共 17 条
[1]  
Foerster John, 1993, P1650
[2]   IMMUNOGLOBULIN CLASS AND SUBCLASS DEFICIENCIES PRIOR TO EPSTEIN-BARR-VIRUS INFECTION IN MALES WITH X-LINKED LYMPHOPROLIFERATIVE DISEASE [J].
GRIERSON, HL ;
SKARE, J ;
HAWK, J ;
PAUZA, M ;
PURTILO, DT .
AMERICAN JOURNAL OF MEDICAL GENETICS, 1991, 40 (03) :294-297
[3]   INFLAMMATORY BOWEL-DISEASE REVISITED - NEWER DRUGS [J].
HANAUER, SB .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 1990, 25 :97-106
[4]  
HENTER JI, 1991, SEMIN ONCOL, V18, P29
[5]  
MROCZEK EC, 1987, ARCH PATHOL LAB MED, V111, P530
[6]   FATAL INFECTIOUS MONONUCLEOSIS - CRITICAL REVIEW [J].
PENMAN, HG .
JOURNAL OF CLINICAL PATHOLOGY, 1970, 23 (09) :765-+
[7]  
PURTILO DT, 1976, LANCET, V2, P882
[8]  
PURTILO DT, 1992, LAB INVEST, V67, P5
[9]  
PURTILO DT, 1989, AM J MED, V87, P421
[10]  
PURTILO DT, 1991, SPRINGER SEMIN IMMUN, V13, P181