title: Hemophagocytic syndrome caused by fulminant ulcerative colitis and cytomegalovirus infection: report of a case.
abstract: 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.
authors.affiliation: Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. koketsu-tky@umin.ac.jp
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Koketsu
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Watanabe
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Hori
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Umetani
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takazawa
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nagawa
mesh_terms: 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
chemical_list: D000998:Antiviral Agents; D005719:gamma-Globulins; D016179:Granulocyte Colony-Stimulating Factor; D015774:Ganciclovir