[Epstein-Barr virus-related lymphomas in patients with inflammatory bowel disease].
During treatment for inflammatory bowel disease (IBD) 2 men with ulcerative colitis, aged 52 and 38 years, and a 37-year-old man with Crohn's disease developed Epstein-Barr virus (EBV)-related non-Hodgkin's B-cell lymphoma. The first 2 patients underwent proctocolectomy and the use of immunosuppressive agents was discontinued, after which the lymphoma disappeared. The third patient had icterus, hepatosplenomegaly and pancytopenia; he died from multiple organ failure. Azathioprine and 6-mercaptopurine are first choice therapy in the treatment of steroid-refractory IBD. These immunomodulating agents are associated with the development of EBV-positive lymphomas in the setting of solid organ transplantation. This type of lymphoma is a rare complication in IBD, although the incidence in referral centres appears to be increasing. Since azathioprine is an important drug in IBD, there is a need for identification of IBD patients at risk of developing a lymphoma. EBV-DNA in plasma or in faeces may be a candidate tumour marker.
Juffermans
N P
NP
Afd. Interne Geneeskunde, divisie Hematologie, Academisch Medisch Centrum/Universiteit van Amsterdam, Amsterdam.
Jager
A
A
Kersten
M J
MJ
van Oers
M H
MH
Hommes
D W
DW
D000328:Adult; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D017809:Fatal Outcome; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D015994:Incidence; D016393:Lymphoma, B-Cell / Q000821:virology*; D008297:Male; D015122:Mercaptopurine / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D012307:Risk Factors
D007166:Immunosuppressive Agents; D015122:Mercaptopurine; D001379:Azathioprine