Cytomegalovirus associated hemophagocytic lymphohistiocytosis in patients suffering from crohnʼs disease treated by azathioprine: A series of four cases

Nguyen, Yohan; Baumard, S.; Salmon, Jessica; Lemoine, Louis; Lévêque, Nicolas; Servettaz, Amélie; Jaussaud, R.; Strady, C.

doi:10.1002/ibd.21770

Cited by 22 publications

(10 citation statements)

References 7 publications

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“…Septic complications may be masked from the underlying hyperinflammatory state caused by HLH. Emergent surgery for intestinal resections or embolization was part of successful treatment in some reports [ 15 , 20 , 36 ]; in others, similar to our patients, it did not help control bleeding definitively [ 11 , 19 , 20 , 22 ]. Administration of recombinant activated factor VII seemed to provide short temporary but no definitive control of bleeding in some reports [ 22 , 37 ].…”

Section: Discussionmentioning

confidence: 47%

Hemophagocytic Lymphohistiocytosis and Gastrointestinal Bleeding: What a Surgeon Should Know

Popeskou

Gavillet

Demartines

et al. 2015

Case Reports in Surgery

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This paper presents to the surgical community an unusual and often ignored cause of gastrointestinal bleeding. Hemophagocytic syndrome or hemophagocytic lymphohistiocytosis (HLH) is a rare medical entity characterized by phagocytosis of red blood cells, leucocytes, platelets, and their precursors in the bone marrow by activated macrophages. When intestinal bleeding is present, the management is very challenging with extremely high mortality rates. Early diagnosis and treatment seem to be the most important factors for a successful outcome. We present two cases and review another 18 from the literature.

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Section: Discussionmentioning

confidence: 47%

Hemophagocytic Lymphohistiocytosis and Gastrointestinal Bleeding: What a Surgeon Should Know

Popeskou

Gavillet

Demartines

et al. 2015

Case Reports in Surgery

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“…1,2 Recently, we demonstrated that the CMV DNA load determined in intestinal tissue was predictive of resistance to steroid treatment and to three-drug regimens in ulcerative colitis (UC). 3 Crohn's disease (CD) may also be associated with CMV infection [4][5][6][7] but in a proportion of patients that needs to be carefully evaluated in order to refine the present recommendations regarding the diagnosis and treatment of CMV infection in IBD.…”

Section: Prevalence Of Cytomegalovirus Infection In Steroidrefractorymentioning

confidence: 99%

Prevalence of Cytomegalovirus Infection in Steroid-refractory Crohnʼs Disease

Roblin

Pillet

Berthelot

et al. 2012

Inflammatory Bowel Diseases

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“…CMV pneumonitis has been reported in 10 CD patients, as reviewed by Cascio et al (2012), while it is rarer in ulcerative colitis [4,[12][13][14][15][16][17][18][19][20]. Hookey et al reported a similar case to the presented patient, where a 19-year-old student with quiescent CD under therapy with 6-MP, developed CMV pneumonitis with a favorable outcome [21].…”

Section: Discussionmentioning

confidence: 68%

Quiescent Crohn’s Disease in Clinical Remission With 6-Mercaptopurine: A Breeding Ground for CMV Pneumonia as Part of a Viral Infection Domino

Panos

2014

J Med Cases

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Cytomegalovirus (CMV) infection is frequently associated with inflammatory bowel disease (IBD). CMV pneumonitis has been reported infrequently in patients with IBD, while there has been one such report in a patient with quiescent Crohn's disease (CD) under long-term immunosuppressant treatment with 6-mercaptopurine (6-MP). We present an unusual case of a 24-year-old male, with fistulized CD in clinical remission under 6-MP, who presented with fever and increased seropurulent fistulae effusion. Shortly after admission, he presented nonproductive cough, pancytopenia, elevated serum aminotransferases, hypoxemia and bilateral pulmonary reticulonodular infiltrates expanding from basal bronchopulmonary segments towards the hila. Positive CMV IgM/IgG, pp65 antigen and CMV-PCR confirmed the diagnosis of CMV pneumonitis. Enterococcus faecium and faecalis were also separately isolated from cultures of two different, concurrent enterocutaneous fistulae. Successful treatment included antiviral and appropriate antibiotic therapy. A subsequent adenovirus co-infection in this patient, demonstrating a viral domino phenomenon, illustrates the difficulty of establishing a final diagnosis in a complex case.

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Cytomegalovirus associated hemophagocytic lymphohistiocytosis in patients suffering from crohnʼs disease treated by azathioprine: A series of four cases

Cited by 22 publications

References 7 publications

Hemophagocytic Lymphohistiocytosis and Gastrointestinal Bleeding: What a Surgeon Should Know

Hemophagocytic Lymphohistiocytosis and Gastrointestinal Bleeding: What a Surgeon Should Know

Prevalence of Cytomegalovirus Infection in Steroid-refractory Crohnʼs Disease

Quiescent Crohn’s Disease in Clinical Remission With 6-Mercaptopurine: A Breeding Ground for CMV Pneumonia as Part of a Viral Infection Domino

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