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Review
. 2013 May;28(3):352-5.
doi: 10.3904/kjim.2013.28.3.352. Epub 2013 May 1.

A case of hemophagocytic syndrome in a patient with fulminant ulcerative colitis superinfected by cytomegalovirus

Jun Il Mun  1 , Sung Jae Shin, Byung Hyun Yu, Jee Hoon Koo, Dong Hoon Kim, Ki Myoung Lee, Kwang Jae Lee
Affiliations
Review

A case of hemophagocytic syndrome in a patient with fulminant ulcerative colitis superinfected by cytomegalovirus

Jun Il Mun et al. Korean J Intern Med. 2013 May.

Abstract

Hemophagocytic syndrome (HPS) is an uncommon hematological disorder that manifests as fever, splenomegaly, and jaundice, with hemophagocytosis in the bone marrow and other tissues pathologically. Secondary HPS is associated with malignancy and infection, especially viral infection. The prevalence of cytomegalovirus (CMV) infection in ulcerative colitis (UC) patients is approximately 16%. Nevertheless, HPS in UC superinfected by CMV is very rare. A 52-year-old female visited the hospital complaining of abdominal pain and hematochezia for 6 days. She was diagnosed with UC 3 years earlier and had been treated with sulfasalazine, but had stopped her medication 4 months earlier. On admission, her spleen was enlarged. The peripheral blood count revealed pancytopenia and bone marrow aspiration smears showed hemophagocytosis. Viral studies revealed CMV infection. She was treated successfully with ganciclovir. We report this case with a review of the related literature.

Keywords: Colitis, ulcerative; Cytomegalovirus infections; Inflammatory bowel diseases; Lymphohistiocytosis, hemophagocytic.

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Conflict of interest statement

No potential conflict of interest relevant to this article is reported.

Figures

Figure 1
Figure 1
Bone marrow biopsy findings. (A) The biopsy section shows hypocellularity (H&E, × 200) and (B) histiocytes containing red blood cells (black arrow), and cellular debris or particles (Wright & Giemsa stain, × 1,000).
Figure 2
Figure 2
Sigmoidoscopic findings. (A) A continuous hyperemic friable mucosal lesion with spontaneous bleeding is observed, and (B) multiple pseudopolyps (black arrow) are noted.
Figure 3
Figure 3
The sigmoidoscopic biopsy shows giant cells with intranuclear and cytoplasmic inclusion bodies (black arrow) (H&E, × 400).
See this image and copyright information in PMC

References

    1. James DG, Stone CD, Wang HL, Stenson WF. Reactive hemophagocytic syndrome complicating the treatment of inflammatory bowel disease. Inflamm Bowel Dis. 2006;12:573–580. - PubMed
    1. Janka GE. Hemophagocytic syndromes. Blood Rev. 2007;21:245–253. - PubMed
    1. Kim JJ, Simpson N, Klipfel N, Debose R, Barr N, Laine L. Cytomegalovirus infection in patients with active inflammatory bowel disease. Dig Dis Sci. 2010;55:1059–1065. - PubMed
    1. Begos DG, Rappaport R, Jain D. Cytomegalovirus infection masquerading as an ulcerative colitis flare-up: case report and review of the literature. Yale J Biol Med. 1996;69:323–328. - PMC - PubMed
    1. Koketsu S, Watanabe T, Hori N, Umetani N, Takazawa Y, Nagawa H. Hemophagocytic syndrome caused by fulminant ulcerative colitis and cytomegalovirus infection: report of a case. Dis Colon Rectum. 2004;47:1250–1253. - PubMed

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