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.
Copyright © 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Adolescent
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Antibodies, Monoclonal, Murine-Derived / therapeutic use*
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Azathioprine / adverse effects*
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Azathioprine / therapeutic use
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Crohn Disease / complications
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Crohn Disease / drug therapy*
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Crohn Disease / immunology
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Epstein-Barr Virus Infections / complications
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Epstein-Barr Virus Infections / drug therapy*
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Epstein-Barr Virus Infections / immunology
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Female
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Humans
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Immunocompromised Host*
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Immunologic Factors / therapeutic use
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Immunosuppressive Agents / adverse effects*
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Immunosuppressive Agents / therapeutic use
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Lymphohistiocytosis, Hemophagocytic / complications
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Lymphohistiocytosis, Hemophagocytic / drug therapy*
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Lymphohistiocytosis, Hemophagocytic / immunology
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Lymphohistiocytosis, Hemophagocytic / virology
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Rituximab
Substances
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Antibodies, Monoclonal, Murine-Derived
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Immunologic Factors
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Immunosuppressive Agents
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Rituximab
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Azathioprine
Supplementary concepts
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Pediatric Crohn's disease