A case of EBV driven haemophagocytic lymphohistiocytosis complicating a teenage Crohn's disease patient on azathioprine, successfully treated with rituximab

J Crohns Colitis. 2013 May;7(4):314-7. doi: 10.1016/j.crohns.2012.05.002. Epub 2012 May 27.

Abstract

We report a case of Epstein-Barr virus infection with the subsequent development of haemophagocytic lymphohistiocytosis in a teenage Crohn's disease patient treated with azathioprine. We found that the early introduction of the anti-B cell monoclonal antibody rituximab precipitated a rapid fall in circulating B-cells and EBV viral load, resulting in a prompt and sustained recovery from what is a potentially fatal complication of azathioprine therapy in Crohn's disease patients.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use*
  • Azathioprine / adverse effects*
  • Azathioprine / therapeutic use
  • Crohn Disease / complications
  • Crohn Disease / drug therapy*
  • Crohn Disease / immunology
  • Epstein-Barr Virus Infections / complications
  • Epstein-Barr Virus Infections / drug therapy*
  • Epstein-Barr Virus Infections / immunology
  • Female
  • Humans
  • Immunocompromised Host*
  • Immunologic Factors / therapeutic use
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Lymphohistiocytosis, Hemophagocytic / complications
  • Lymphohistiocytosis, Hemophagocytic / drug therapy*
  • Lymphohistiocytosis, Hemophagocytic / immunology
  • Lymphohistiocytosis, Hemophagocytic / virology
  • Rituximab

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Immunologic Factors
  • Immunosuppressive Agents
  • Rituximab
  • Azathioprine

Supplementary concepts

  • Pediatric Crohn's disease