Hemophagocytic syndrome caused by fulminant ulcerative colitis and cytomegalovirus infection: report of a case.
We report a case of hemophagocytic syndrome that developed in a 35-year-old, Japanese male with fulminant ulcerative colitis. The patient underwent an emergency operation, consisting of subtotal colectomy, ileostomy with rectal preservation (suprapubic mucous fistula). After the operation, peripheral blood counts showed progressive pancytopenia and bone marrow aspirate smears revealed hypocellular bone marrow with an increase in histiocytes, indicating hemophagocytic syndrome. Viral studies (serum antibody titer and antigenemia of cytomegalovirus) revealed systemic cytomegalovirus infection. The patient was diagnosed with virus-associated hemophagocytic syndrome and was successfully treated with antiviral therapy consisting of intravenous ganciclovir, gamma globulin, and granulocyte-colony stimulating factor.
Koketsu
Shin-Ichiro
S
Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. koketsu-tky@umin.ac.jp
Watanabe
Toshiaki
T
Hori
Nobukazu
N
Umetani
Naoyuki
N
Takazawa
Yutaka
Y
Nagawa
Hirokazu
H
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000150:complications* / Q000601:surgery; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000188:drug therapy; D015774:Ganciclovir / Q000627:therapeutic use; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D015616:Histiocytosis, Non-Langerhans-Cell / Q000821:virology*; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D005719:gamma-Globulins / Q000627:therapeutic use
D000998:Antiviral Agents; D005719:gamma-Globulins; D016179:Granulocyte Colony-Stimulating Factor; D015774:Ganciclovir